| Black Rock Vision Center | |
|
3201 Lakeside Dr, Reno, NV 89509-4830 | |
| (775) 825-0559 | |
| (775) 829-7918 |
| Full Name | Black Rock Vision Center |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 3201 Lakeside Dr, Reno, Nevada |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235550146 | NPI | - | NPPES |
| 100533928 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 779 (Nevada) | Primary |
| Provider Name | Brant M Southam |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1831427160 PECOS PAC ID: 4385786805 Enrollment ID: I20140506001464 |
| Provider Name | Shaune K. Wallace |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1467550335 PECOS PAC ID: 6103824636 Enrollment ID: I20170725003431 |
| Provider Name | Corom Dumayne Eisley |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1568957744 PECOS PAC ID: 0648522482 Enrollment ID: I20190613002746 |
| Provider Name | Rylee Marie Ziegler |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1861273096 PECOS PAC ID: 2860848520 Enrollment ID: I20231101001106 |
| Mailing Address | Practice Location Address |
|---|---|
| Black Rock Vision Center 3201 Lakeside Dr, Reno, NV 89509-4830 Ph: (775) 825-0559 | Black Rock Vision Center 3201 Lakeside Dr, Reno, NV 89509-4830 Ph: (775) 825-0559 |
Jeffrey D. Ferris, O.d., P.c. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 5595 S. Virginia St., Suite B, Reno, NV 89502 Phone: 775-828-2300 | |
Dr. Richard Andrew Boren, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 6360 Mae Anne Ave., Suite 1, Reno, NV 89523 Phone: 772-787-9137 Fax: 775-323-3652 | |
Dr. Troy Robert Ogden, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 236 W. 6th St, Suite 100, Reno, NV 89503 Phone: 775-322-4061 Fax: 775-322-6603 | |
Family Eyecare Associates Optometrist Medicare: Not Enrolled in Medicare Practice Location: 18601 Wedge Pkwy, Reno, NV 89511 Phone: 775-358-1020 | |
Kopolow & Girisgen Od Pc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 13921 S Virginia St Ste 116, Reno, NV 89511 Phone: 702-341-7254 | |
Optic Gallery South Meadows Llc Optometrist Medicare: Medicare Enrolled Practice Location: 770 S Meadows Pkwy Ste 108&109, Reno, NV 89521 Phone: 775-224-4543 | |
Dr. David Hubbard, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 10459 Double R Blvd, Reno, NV 89521 Phone: 775-827-3030 Fax: 775-827-5479 |