Provider Demographics
NPI:1578874236
Name:MENDOZA, BILLY GALES (OD)
Entity Type:Individual
Prefix:DR
First Name:BILLY
Middle Name:GALES
Last Name:MENDOZA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 34032
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89533-4032
Mailing Address - Country:US
Mailing Address - Phone:775-232-0951
Mailing Address - Fax:775-376-1116
Practice Address - Street 1:2425 E 2ND ST
Practice Address - Street 2:#1
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1218
Practice Address - Country:US
Practice Address - Phone:775-359-8220
Practice Address - Fax:775-348-8793
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-28
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV671152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist