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General NPI Number Information
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NPI Number | 1053007922
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Entity Type | Individual
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Provider Name | ERIC RICHARD HEALEY
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Gender | Male
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Dates
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Enumeration Date | 04/13/2023
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Last Update Date | 04/13/2023
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Provider Practice Location Address
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Address Line | 3200 LAS VEGAS BLVD S STE 1070
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City | LAS VEGAS
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State | NV
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Zip | 89109-0728
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Country | US
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Telephone | 702-366-7080
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Fax | 702-583-4915
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Provider Business Mailing Address
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Address Line | 925 ANTELOPE WAY
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City | LAS VEGAS
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State | NV
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Zip | 89145-6109
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Country | US
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Telephone | 702-678-4225
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 573
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License Number State | NV
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