MEDICARE: VALLEY OPTICAL

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	332H00000X	Eyewear Supplier

General Provider Information

NPI Number	:	1164604393
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VALLEY OPTICAL

Provider Business Mailing Address
First Line	:	9011 W SAHARA AVE
Second Line	:	SUITE 101
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-4800
Country	:	US
Telephone Number	:	702-794-2020
Fax Number	:	702-732-4108

Provider Business Practice Location Address
First Line	:	9011 W SAHARA AVE
Second Line	:	SUITE 101
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-4800
Country	:	US
Telephone Number	:	702-794-2020
Fax Number	:	702-732-4108

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MELISSA A BEATY
Credential	:	O.D.
Telephone Number	:	702-794-2020

Provider Enumeration Date	:	11/29/2007
Last Update Date	:	11/29/2007

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Directions to “VALLEY OPTICAL ” Practice Location

Language	Start Address	Practice Location

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