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NPI Code Detail

MEDICARE: HENDERSON VISION CARE LLC

MEDICARE: HENDERSON VISION CARE LLC
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
1152W00000XOptometrist

General Provider Information

NPI Number : 1366906976
Entity Type Code : Organization
Provider Name (Legal Business Name) : HENDERSON VISION CARE LLC
Provider Business Mailing Address
First Line : 305 N PECOS RD STE A
Second Line :
City : HENDERSON
State : NV
Zip : 89074-1352
Country : US
Telephone Number : 702-938-0320
Fax Number :
Provider Business Practice Location Address
First Line : 305 N PECOS RD STE A
Second Line :
City : HENDERSON
State : NV
Zip : 89074-1352
Country : US
Telephone Number : 702-938-0320
Fax Number :
Authorized Official
Title or Position : CO OWNER
Name : SPENCER QUINTON
Credential : OD
Telephone Number : 702-938-0320
Provider Enumeration Date : 01/28/2019
Last Update Date : 01/28/2019

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Directions to “HENDERSON VISION CARE LLC ” Practice Location

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