| Dr Grady Joseph Williams Llc | |
|
840 S Rancho Dr Suite 1 Las Vegas NV 89106-3837 | |
| (702) 870-5911 | |
| (702) 870-2368 |
| Full Name | Dr Grady Joseph Williams Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 840 S Rancho Dr, Las Vegas, Nevada |
| Authorized Official Name and Position | Grady Joseph Williams Llc (OWNER) |
| Authorized Official Contact | 7028098899 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Grady Joseph Williams Llc 840 S Rancho Dr Suite 1 Las Vegas NV 89106-3837 Ph: (702) 870-5911 | Dr Grady Joseph Williams Llc 840 S Rancho Dr Suite 1 Las Vegas NV 89106-3837 Ph: (702) 870-5911 |
| NPI Number | 1467644831 |
|---|---|
| Provider Enumeration Date | 08/09/2007 |
| Last Update Date | 10/21/2016 |
| Medicare PECOS PAC ID | 8729179569 |
|---|---|
| Medicare Enrollment ID | O20070808000129 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467644831 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 296 (Nevada) | Primary |
| Provider Name | Grady J Williams |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1346266095 PECOS PAC ID: 9638193808 Enrollment ID: I20070705000274 |
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