Organization
ICARELASVEGAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GABRIEL HERNANDEZ O.D. (SOLE-MEMBER)
(702) 631-4144
Entity
Organization
Contact information
Practice address
6134 W LAKE MEAD BLVD, E-8, LAS VEGAS, NV 89108-2659
(702) 631-4144
(702) 631-9094
Mailing address
6134 W LAKE MEAD BLVD, E-8, LAS VEGAS, NV 89108-2659
(702) 631-4144
(702) 631-9094
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
557
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH615A
MEDICARE PTAN
NV
Enumeration date
07/11/2008
Last updated
06/13/2012
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