Organization
DESERT VISION AND EYE CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD MAZZULLA O.D. (OWNER)
(702) 631-2015
Entity
Organization
Contact information
Practice address
4116 W CRAIG RD STE 104, NORTH LAS VEGAS, NV 89032-2733
(702) 631-2015
(702) 631-2511
Mailing address
8724 AZURE SKY DR, LAS VEGAS, NV 89129-2223
(702) 631-2015
(702) 631-2511
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0231
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0231
—
NV
01
—
1194777219
INDIVIDUAL NPI
NV
Enumeration date
11/18/2010
Last updated
08/27/2014
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