Most Relevant Information
Provider Data
| NPI Number: | 1003211889 |
| Provider Name: | ERIC TOMAS OVALLE PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 5858 |
Most Important Dates
| Enumeration Date: | 10/23/2014 |
| Last Updated: | 11/14/2018 |
Provider Practice Location
3125 N DYSART RD
AVONDALE
AZ
853921208
Practice Location Phone/Fax
| Phone: | 6027268788 |
| Fax: | 4804200732 |
Provider Mailing Location
3125 N DYSART RD
AVONDALE
AZ
853921208
Provider Mailing Phone/Fax
| Phone: | 6027268788 |
| Fax: | 4804200732 |