1811088073 NPI number — TOM SOWASH OD & ASSOCIATES

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811088073 NPI number — TOM SOWASH OD & ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOM SOWASH OD & ASSOCIATES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
EYEMASTERS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1811088073
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 849764
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75284-9764
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-524-6663
Provider Business Mailing Address Fax Number:
210-524-6587

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3111 W CHANDLER BLVD
Provider Second Line Business Practice Location Address:
SUITE 1124
Provider Business Practice Location Address City Name:
CHANDLER
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85226-5071
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-782-9380
Provider Business Practice Location Address Fax Number:
480-782-5415
Provider Enumeration Date:
09/27/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SOWASH
Authorized Official First Name:
TOM
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
720-570-4338

Provider Taxonomy Codes

  • Taxonomy code: 332H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)