Provider Demographics
NPI:1023304912
Name:SUN CITY EYE CARE
Entity type:Organization
Organization Name:SUN CITY EYE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JON
Authorized Official - Middle Name:JOEL
Authorized Official - Last Name:NITARDY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:915-585-1949
Mailing Address - Street 1:750 SUNLAND PARK DR
Mailing Address - Street 2:G1
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-6709
Mailing Address - Country:US
Mailing Address - Phone:915-585-1949
Mailing Address - Fax:915-581-3613
Practice Address - Street 1:750 SUNLAND PARK DR
Practice Address - Street 2:G1
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-6709
Practice Address - Country:US
Practice Address - Phone:915-585-1949
Practice Address - Fax:915-581-3613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-20
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6556T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty