MEDICARE: DR. VORAPAS THUNYALUKUL OD

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
1	152W00000X	Optometrist	12508 TPA	CA
2	152W00000X	Optometrist	447	NV

General Provider Information

NPI Number	:	1184607095
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VORAPAS THUNYALUKUL OD

Provider Business Mailing Address
First Line	:	11051 DESERT HEIGHTS AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89135-3641
Country	:	US
Telephone Number	:	714-677-7405
Fax Number	:

Provider Business Practice Location Address
First Line	:	1450 W HORIZON RIDGE PKWY STE B306
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89012-4480
Country	:	US
Telephone Number	:	702-309-2020
Fax Number	:	702-307-3082

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/23/2005
Last Update Date	:	10/17/2025

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