Individual
GEETHA PARASURAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
775 E FLORENCE BLVD, #2, CASA GRANDE, AZ 85122
(520) 426-1600
Mailing address
220 N MCKEMY AVE, CHANDLER, AZ 85226-2654
(480) 961-1865
(480) 961-8938
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2081
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z179891
MEDICARE PTAN
AZ
01
—
Z179892
MEDICARE PTAN
AZ
01
—
Z179893
MEDICARE PTAN
AZ
01
—
Z179894
MEDICARE PTAN
AZ
01
—
Z179895
MEDICARE PTAN
AZ
01
—
Z179896
MEDICARE PTAN
AZ
Enumeration date
08/19/2015
Last updated
10/07/2015
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