Provider Demographics
NPI:1083044333
Name:LAO, JOSEPH (OD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:LAO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7910 LOOKOUT ROCK CIR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-5365
Mailing Address - Country:US
Mailing Address - Phone:702-538-3335
Mailing Address - Fax:
Practice Address - Street 1:543 N STEPHANIE ST STE 110
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-6613
Practice Address - Country:US
Practice Address - Phone:702-888-1079
Practice Address - Fax:702-333-1016
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD 60423883152W00000X
CA14844152W00000X
NV796152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist