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NPI Code Detail

MEDICARE: PETER W. DEBRY M.D. DBA NV EYE SURGERY

MEDICARE: PETER W. DEBRY M.D. DBA NV EYE SURGERY
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
1207WX0009XGlaucoma Specialist (Ophthalmology) Physician
2207W00000XOphthalmology Physician

Other Identifiers

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

General Provider Information

NPI Number : 1518393222
Entity Type Code : Organization
Provider Name (Legal Business Name) : PETER W. DEBRY M.D. DBA NV EYE SURGERY
Provider Business Mailing Address
First Line : 2850 W HORIZON RIDGE PKWY STE 300
Second Line :
City : HENDERSON
State : NV
Zip : 89052-4395
Country : US
Telephone Number : 702-202-4776
Fax Number :
Provider Business Practice Location Address
First Line : 2390 W HORIZON RIDGE PKWY STE 100
Second Line :
City : HENDERSON
State : NV
Zip : 89052-5084
Country : US
Telephone Number : 702-825-2085
Fax Number : 702-852-5743
Authorized Official
Title or Position : AUTHORIZED OFFICIAL
Name : AMY GRIM
Credential :
Telephone Number : 702-202-4776
Provider Enumeration Date : 09/25/2013
Last Update Date : 03/29/2023

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2390 W HORIZON RIDGE PKWY STE 100
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