MEDICARE: CIVIA MCCAFFREY, OD, P.C.

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

General Provider Information

NPI Number	:	1346805157
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CIVIA MCCAFFREY, OD, P.C.

Provider Business Mailing Address
First Line	:	2968 EL CAMINO RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-5273
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	900 S PAVILION CENTER DR STE 140
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89144-4583
Country	:	US
Telephone Number	:	702-243-8788
Fax Number	:

Authorized Official
Title or Position	:	OPTOMETRIST/OWNER
Name	:	DR. CIVIA MCCAFFREY
Credential	:	OD
Telephone Number	:	702-355-9686

Provider Enumeration Date	:	05/07/2019
Last Update Date	:	12/07/2022

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