Provider Demographics
NPI:1629647763
Name:DESERT CLIFFS EYECARE, PLLC
Entity Type:Organization
Organization Name:DESERT CLIFFS EYECARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:LANGR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-848-2785
Mailing Address - Street 1:4155 S GRAND CANYON DR (C/O DESERT CLIFFS EYECARE PLLC)
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-7123
Mailing Address - Country:US
Mailing Address - Phone:507-461-3420
Mailing Address - Fax:
Practice Address - Street 1:4155 S GRAND CANYON DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-7123
Practice Address - Country:US
Practice Address - Phone:507-461-3420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-23
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty