Provider Demographics
NPI:1376641753
Name:MANOS, CHRYS (OD)
Entity Type:Individual
Prefix:
First Name:CHRYS
Middle Name:
Last Name:MANOS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E WINDMILL LN
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-1843
Mailing Address - Country:US
Mailing Address - Phone:702-437-2889
Mailing Address - Fax:702-437-5196
Practice Address - Street 1:500 E WINDMILL LN
Practice Address - Street 2:SUITE 120
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-1843
Practice Address - Country:US
Practice Address - Phone:702-437-2889
Practice Address - Fax:702-437-5196
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV369152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100509807Medicaid
NVU82457Medicare UPIN
NVCT739ZMedicare PIN