Optic Gallery Henderson, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

796 Issued in NV

Legal business name

OPTIC GALLERY HENDERSON, LLC

Practice address

543 N Stephanie St
Suite 110
Henderson, NV 89014-6613

Phone

(702) 888-1079

Fax

(702) 333-1016

NPI assigned

May 21, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Joseph Lao, OD

Title

Optometrist

Phone

(702) 888-1079

Specialties & licenses 1

Addresses

Other names 1

• Optic Gallery Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1463788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463788800000",
    "number": "1407203201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "543 N STEPHANIE ST",
            "address_2": "SUITE 110",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890146613",
            "telephone_number": "702-888-1079",
            "fax_number": "702-333-1016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "543 N STEPHANIE ST",
            "address_2": "SUITE 110",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890146613",
            "telephone_number": "702-888-1079",
            "fax_number": "702-333-1016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIC GALLERY HENDERSON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-21",
        "last_updated": "2016-05-21",
        "status": "A",
        "authorized_official_last_name": "LAO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "702-888-1079",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NV",
            "license": "796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optic Gallery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Henderson, NV
• Providers in Henderson, NV by specialty
• Optometrist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.