Healthcare Provider Details

I. General information

NPI: 1518393222
Provider Name (Legal Business Name): PETER W. DEBRY M.D. DBA NV EYE SURGERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2013
Last Update Date: 03/29/2023
Certification Date: 03/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2390 W HORIZON RIDGE PKWY STE 100
HENDERSON NV
89052-5084
US

IV. Provider business mailing address

2850 W HORIZON RIDGE PKWY STE 300
HENDERSON NV
89052-4395
US

V. Phone/Fax

Practice location:
  • Phone: 702-825-2085
  • Fax: 702-852-5743
Mailing address:
  • Phone: 702-202-4776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License Number
License Number State

VIII. Authorized Official

Name: AMY GRIM
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 702-202-4776