Provider Demographics
NPI:1851700157
Name:DR. BOB BROOKS & ASSOCIATES, OPTOMETRISTS, PLLC
Entity type:Organization
Organization Name:DR. BOB BROOKS & ASSOCIATES, OPTOMETRISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:520-747-7984
Mailing Address - Street 1:5950 E BROADWAY BLVD
Mailing Address - Street 2:SEARS OPTICAL
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-3904
Mailing Address - Country:US
Mailing Address - Phone:520-747-7984
Mailing Address - Fax:520-747-8418
Practice Address - Street 1:5950 E BROADWAY BLVD
Practice Address - Street 2:SEARS OPTICAL
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-3904
Practice Address - Country:US
Practice Address - Phone:520-747-7984
Practice Address - Fax:520-747-8418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty