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NPI Code Detail

MEDICARE: MISS THERESA CHONG O.D.

MEDICARE: MISS THERESA CHONG O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152WL0500XLow Vision Rehabilitation Optometrist002749CT

General Provider Information

NPI Number : 1083878789
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS THERESA CHONG O.D.
Provider Business Mailing Address
First Line : 6900 PECOS RD
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89086-4400
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6900 PECOS RD
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89086-4400
Country : US
Telephone Number : 702-791-9000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2008
Last Update Date : 02/12/2026

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Directions to “ MISS THERESA CHONG O.D.” Practice Location

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