Provider Demographics
NPI:1730777004
Name:ENVISION EYECARE CENTER
Entity type:Organization
Organization Name:ENVISION EYECARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:520-293-2363
Mailing Address - Street 1:525 W WETMORE RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-5093
Mailing Address - Country:US
Mailing Address - Phone:520-293-2363
Mailing Address - Fax:520-293-0475
Practice Address - Street 1:525 W WETMORE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-5093
Practice Address - Country:US
Practice Address - Phone:520-293-2363
Practice Address - Fax:520-293-0475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-04
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty