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General NPI Number Information
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NPI Number | 1063835155
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Entity Type | Organization
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Legal Business Name | DOCTOR GOLDENEYE LLC
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Dates
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Enumeration Date | 01/27/2014
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 501 KEYSTONE AVE
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City | RENO
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State | NV
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Zip | 89503
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Country | US
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Telephone | 775-322-3777
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Fax | 775-376-1116
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Provider Business Mailing Address
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Address Line | PO BOX 34032
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City | RENO
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State | NV
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Zip | 89533-4032
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Country | US
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Telephone | 775-322-3777
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Fax | 775-376-1116
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Authorized Official
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Title or Position | OWNER, PRESIDENT
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Name | BILLY GALES MENDOZA
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Credential | OD
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Telephone | 775-322-3777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 671
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License Number State | NV
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