MEDICARE: HERA ANSARI 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	1067	NV

General Provider Information

NPI Number	:	1427684992
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HERA ANSARI OD

Provider Business Mailing Address
First Line	:	11165 VETERANS PKWY UNIT 2047
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89521-9356
Country	:	US
Telephone Number	:	609-334-0470
Fax Number	:

Provider Business Practice Location Address
First Line	:	3475 GS RICHARDS BLVD STE 130
Second Line	:
City	:	CARSON CITY
State	:	NV
Zip	:	89703-8462
Country	:	US
Telephone Number	:	775-841-2000
Fax Number	:	775-841-4200

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

Provider Enumeration Date	:	03/17/2020
Last Update Date	:	01/26/2026

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