Provider Demographics
NPI:1639205818
Name:ROWAN, DANIEL T (OD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:T
Last Name:ROWAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9700 SOUTH MCCARRAN BLVD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523
Mailing Address - Country:US
Mailing Address - Phone:775-827-3937
Mailing Address - Fax:775-746-5316
Practice Address - Street 1:9700 S MCCARRAN BLVD
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89523-9203
Practice Address - Country:US
Practice Address - Phone:775-827-3937
Practice Address - Fax:775-746-5316
Is Sole Proprietor?:No
Enumeration Date:2007-02-24
Last Update Date:2023-08-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV437152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1639205818Medicaid
NV5956120001Medicare NSC
X13565Medicare UPIN
NVDC618AMedicare PIN