Provider Demographics
NPI:1336933373
Name:UY, ADRIAN (LDO)
Entity type:Individual
Prefix:
First Name:ADRIAN
Middle Name:
Last Name:UY
Suffix:
Gender:
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21055 E RITTENHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-4477
Mailing Address - Country:US
Mailing Address - Phone:480-457-1958
Mailing Address - Fax:480-457-1960
Practice Address - Street 1:21055 E RITTENHOUSE RD
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-4477
Practice Address - Country:US
Practice Address - Phone:480-457-1958
Practice Address - Fax:480-457-1960
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLDO-003229156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician