Provider Demographics
NPI:1013652692
Name:DESERT EYE ASSOCIATES LTD
Entity type:Organization
Organization Name:DESERT EYE ASSOCIATES LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TURENNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-327-5677
Mailing Address - Street 1:1110 N EL DORADO PL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-4606
Mailing Address - Country:US
Mailing Address - Phone:520-327-5677
Mailing Address - Fax:520-547-2135
Practice Address - Street 1:10350 E DREXEL RD STE 230
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85747-9405
Practice Address - Country:US
Practice Address - Phone:520-202-0401
Practice Address - Fax:520-325-2335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-28
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1679913818Medicaid
AZ1043293566Medicaid
AZ1275105637Medicaid
AZ1154391332Medicaid
AZ1427287838Medicaid
AZ1982669933Medicaid