Provider Demographics
NPI:1902133739
Name:I DRS, INC.
Entity Type:Organization
Organization Name:I DRS, INC.
Other - Org Name:ALL ABOUT EYES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:SHIBATA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:623-551-9122
Mailing Address - Street 1:42201 N 41ST DR
Mailing Address - Street 2:SUITE 144
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-3800
Mailing Address - Country:US
Mailing Address - Phone:623-551-9122
Mailing Address - Fax:623-551-9120
Practice Address - Street 1:42201 N 41ST DR
Practice Address - Street 2:SUITE 144
Practice Address - City:ANTHEM
Practice Address - State:AZ
Practice Address - Zip Code:85086-3800
Practice Address - Country:US
Practice Address - Phone:623-551-9122
Practice Address - Fax:623-551-9120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-16
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1174152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty