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NPI Code Detail

MEDICARE: EYES ON LAS VEGAS

MEDICARE: EYES ON LAS VEGAS
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
1152W00000XOptometrist342NV

General Provider Information

NPI Number : 1760682348
Entity Type Code : Organization
Provider Name (Legal Business Name) : EYES ON LAS VEGAS
Provider Business Mailing Address
First Line : 4960 S FORT APACHE RD
Second Line : SUITE 450
City : LAS VEGAS
State : NV
Zip : 89148-1743
Country : US
Telephone Number : 702-385-3937
Fax Number : 702-385-3938
Provider Business Practice Location Address
First Line : 4960 S FORT APACHE RD
Second Line : SUITE 450
City : LAS VEGAS
State : NV
Zip : 89148-1743
Country : US
Telephone Number : 702-385-3937
Fax Number : 702-385-3938
Authorized Official
Title or Position : PRESIDENT
Name : DR. JOSEPH C PFONDEVIDA
Credential : O.D.
Telephone Number : 702-385-3937
Provider Enumeration Date : 07/20/2007
Last Update Date : 07/20/2007

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Directions to “EYES ON LAS VEGAS ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.