Provider Demographics
NPI:1083661342
Name:HSUEH, KAREN J (OD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:J
Last Name:HSUEH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:J
Other - Last Name:HIDROSOLLO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5288 SPRING MOUNTAIN RD
Mailing Address - Street 2:STE102
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-8714
Mailing Address - Country:US
Mailing Address - Phone:702-697-0888
Mailing Address - Fax:702-876-8088
Practice Address - Street 1:5288 SPRING MOUNTAIN RD
Practice Address - Street 2:STE102
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-8714
Practice Address - Country:US
Practice Address - Phone:702-697-0888
Practice Address - Fax:702-876-8088
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV536152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV7977790OtherAETNA
NV7977790OtherAETNA
NVV08691Medicare UPIN