Provider Demographics
NPI:1215747449
Name:OZARK EYE, PLLC
Entity type:Organization
Organization Name:OZARK EYE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TRENT
Authorized Official - Middle Name:
Authorized Official - Last Name:DAIBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-208-6175
Mailing Address - Street 1:1118 NW G ST
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-4235
Mailing Address - Country:US
Mailing Address - Phone:479-857-3838
Mailing Address - Fax:
Practice Address - Street 1:455 SLACK ST
Practice Address - Street 2:
Practice Address - City:PEA RIDGE
Practice Address - State:AR
Practice Address - Zip Code:72751
Practice Address - Country:US
Practice Address - Phone:479-208-6175
Practice Address - Fax:479-208-6173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-09
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty