MEDICARE: DEXTER A MORRIS OD LTD

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	239	NV

General Provider Information

NPI Number	:	1710291174
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEXTER A MORRIS OD LTD

Provider Business Mailing Address
First Line	:	3413 S EASTERN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89169-3314
Country	:	US
Telephone Number	:	702-796-1419
Fax Number	:	702-796-4989

Provider Business Practice Location Address
First Line	:	3413 S EASTERN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89169-3314
Country	:	US
Telephone Number	:	702-796-1419
Fax Number	:	702-796-4989

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DEXTER AL MORRIS
Credential	:	O.D.
Telephone Number	:	702-796-1419

Provider Enumeration Date	:	07/28/2010
Last Update Date	:	07/30/2010

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