Individual
JUDY BRESHEARS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
555 N GILBERT RD, SUITE 101, MESA, AZ 85203-7551
(480) 827-9184
(480) 461-0703
Mailing address
16013 E GLENDORA DR, FOUNTAIN HILLS, AZ 85268-3101
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1101
OK
152W00000X
Optometrist
Primary
885
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DB1051
RAILROAD MEDICARE GROUP ID
AZ
01
—
P00112635
RAILROAD MEDICARE PIN
AZ
Enumeration date
11/15/2006
Last updated
12/10/2008
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