MEDICARE: MANTHEI EYE PHYSICIANS LIMITED

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	332B00000X	Durable Medical Equipment & Medical Supplies		NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083961262
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MANTHEI EYE PHYSICIANS LIMITED

Provider Business Mailing Address
First Line	:	1505 WIGWAM PKWY STE 100
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-8195
Country	:	US
Telephone Number	:	702-896-6043
Fax Number	:	702-896-9591

Provider Business Practice Location Address
First Line	:	9100 W POST RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-2418
Country	:	US
Telephone Number	:	702-896-6043
Fax Number	:	702-896-9591

Authorized Official
Title or Position	:	OWNER
Name	:	DARRICK NEIBAUR
Credential	:	DO
Telephone Number	:	702-896-6043

Provider Enumeration Date	:	08/07/2012
Last Update Date	:	06/19/2020

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Directions to “MANTHEI EYE PHYSICIANS LIMITED ” Practice Location

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