Optic Gallery Henderson, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

796 Issued in NV

Legal business name

OPTIC GALLERY HENDERSON, LLC

Doing business as

Optic Gallery

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

Last updated

May 21, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Joseph Lao, ODNPI 1083044333

Title

Optometrist

Phone

(702) 888-1079

Specialties & licenses 1

Addresses

Other names 1

• Optic Gallery Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joseph Lao, O.D.

  • Optometrist
  • Henderson, NV
  • NPI 1083044333
  Authorized official Same address or phone

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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• Optima Change Management, LLC (Optima Healing and Recovery)

• 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.