MEDICARE: JENNIFER CHOW OD

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
1	152W00000X	Optometrist	533	NV

General Provider Information

NPI Number	:	1023104775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER CHOW OD

Provider Business Mailing Address
First Line	:	6935 ALIANTE PKWY
Second Line	:	STE. 102
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89084-5818
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6935 ALIANTE PKWY
Second Line	:	STE. 102
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89084-5818
Country	:	US
Telephone Number	:	702-685-4320
Fax Number	:	702-685-4583

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	07/07/2011

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