Provider Demographics
NPI:1710707716
Name:EYE FORS PLLC
Entity type:Organization
Organization Name:EYE FORS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OD/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:INGA
Authorized Official - Middle Name:LILLIANA
Authorized Official - Last Name:FORS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:623-214-0353
Mailing Address - Street 1:16968 W BELL RD STE 402
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-8943
Mailing Address - Country:US
Mailing Address - Phone:623-214-0353
Mailing Address - Fax:
Practice Address - Street 1:16968 W BELL RD STE 402
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-8943
Practice Address - Country:US
Practice Address - Phone:623-214-0353
Practice Address - Fax:623-214-0693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Multi-Specialty
No152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Multi-Specialty