MEDICARE: DR. DAVID P YESNICK 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
1	152WL0500X	Low Vision Rehabilitation Optometrist	335	NV
2	152W00000X	Optometrist	335	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255377040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID P YESNICK O.D.

Provider Business Mailing Address
First Line	:	9191 W FLAMINGO RD STE 120
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-6859
Country	:	US
Telephone Number	:	702-966-2020
Fax Number	:	702-966-2022

Provider Business Practice Location Address
First Line	:	9191 W FLAMINGO RD STE 120
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-6859
Country	:	US
Telephone Number	:	702-966-2020
Fax Number	:	702-966-2022

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

Provider Enumeration Date	:	06/21/2006
Last Update Date	:	02/23/2019

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