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NPI Code Detail

MEDICARE: ANHTON QUY LE O.D.

MEDICARE: ANHTON QUY LE 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
1152W00000XOptometrist462NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
128947OTHERNVSPECTERA
27075397OTHERNVAETNA

General Provider Information

NPI Number : 1952459216
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANHTON QUY LE O.D.
Provider Business Mailing Address
First Line : 7277 SASHAYING SPIRIT CT
Second Line :
City : LAS VEGAS
State : NV
Zip : 89131-2356
Country : US
Telephone Number : 702-328-7296
Fax Number : 702-898-2015
Provider Business Practice Location Address
First Line : 6555 N DECATUR BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89131-2796
Country : US
Telephone Number : 702-233-2015
Fax Number : 702-898-2015
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2007
Last Update Date : 06/11/2008

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