Provider Demographics
NPI:1083375596
Name:MARK W. DOUBRAVA M.D. DBA EYE CARE FOR NEVADA
Entity Type:Organization
Organization Name:MARK W. DOUBRAVA M.D. DBA EYE CARE FOR NEVADA
Other - Org Name:EYE CARE FOR NEVADA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:W
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-794-2020
Mailing Address - Street 1:9011 W SAHARA AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-4801
Mailing Address - Country:US
Mailing Address - Phone:702-794-2020
Mailing Address - Fax:702-732-4108
Practice Address - Street 1:9011 W SAHARA AVE STE 101
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-4801
Practice Address - Country:US
Practice Address - Phone:702-794-2020
Practice Address - Fax:702-732-4108
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARK W. DOUBRAVA M.D.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0120XAllopathic & Osteopathic PhysiciansOphthalmologyCornea and External Diseases SpecialistGroup - Single Specialty