Individual
HERSEL LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
276 KINGSBURY GRADE # 103, STATELINE, NV 89449-9804
(775) 588-3500
Mailing address
9700 S MCCARRAN BLVD, RENO, NV 89523-9203
(775) 827-3937
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
2345T
OR
152W00000X
Optometrist
Primary
939
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
071115000
REGENCE BLUE CROSS
OR
Enumeration date
07/05/2005
Last updated
01/26/2021
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