Provider Demographics
NPI:1215380530
Name:VALLEY VISION EYE CARE
Entity Type:Organization
Organization Name:VALLEY VISION EYE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:702-397-2020
Mailing Address - Street 1:1170 N MOAPA VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:OVERTON
Mailing Address - State:NV
Mailing Address - Zip Code:89040
Mailing Address - Country:US
Mailing Address - Phone:702-397-2020
Mailing Address - Fax:
Practice Address - Street 1:1170 N MOAPA VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:OVERTON
Practice Address - State:NV
Practice Address - Zip Code:89040
Practice Address - Country:US
Practice Address - Phone:702-397-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-21
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9043-T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty