| |
1505 Wigwam Pkwy Ste 100, Henderson, NV 89074-8195 | |
(702) 896-6043 | |
(702) 896-9591 |
Full Name | |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 1505 Wigwam Pkwy Ste 100, Henderson, Nevada |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1568032522 | NPI | - | NPPES |
1568032522 | Medicaid | NV |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
1505 Wigwam Pkwy Ste 100, Henderson, NV 89074-8195 Ph: (702) 896-6043 | 1505 Wigwam Pkwy Ste 100, Henderson, NV 89074-8195 Ph: (702) 896-6043 |