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General NPI Number Information
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NPI Number | 1265692826
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Entity Type | Organization
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Legal Business Name | DYNAMIC EYE CARE
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Dates
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Enumeration Date | 06/16/2008
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Last Update Date | 08/11/2009
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Provider Practice Location Address
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Address Line | 6935 ALIANTE PKWY SUITE 102
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89084-5818
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Country | US
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Telephone | 702-685-4320
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Fax | 702-685-4583
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Provider Business Mailing Address
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Address Line | 6935 ALIANTE PKWY SUITE 102
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89084-5818
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Country | US
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Telephone | 702-685-4320
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Fax | 702-685-4583
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Authorized Official
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Title or Position | OWNER
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Name | DR. SUZANNE TRAN
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Credential | O.D.
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Telephone | 714-553-1826
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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 | 506
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License Number State | NV
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