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NPI Code Detail

MEDICARE: JORDAN HUI O.D.

MEDICARE: JORDAN HUI O.D.
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
1152W00000XOptometrist520NV
2152W00000XOptometrist12585TCA

General Provider Information

NPI Number : 1164638169
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDAN HUI O.D.
Provider Business Mailing Address
First Line : 2120 CACTUS PINE CT
Second Line :
City : LAS VEGAS
State : NV
Zip : 89135-1089
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5101 S PECOS RD # 1
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-1269
Country : US
Telephone Number : 702-898-2383
Fax Number : 702-898-5383
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2007
Last Update Date : 07/08/2007

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