Provider Demographics
NPI:1649388794
Name:DEMERS FAMILY VISION GROUP, INC.
Entity Type:Organization
Organization Name:DEMERS FAMILY VISION GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:DEMERS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:775-358-1317
Mailing Address - Street 1:670 N MCCARRAN BLVD
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-4600
Mailing Address - Country:US
Mailing Address - Phone:775-358-1317
Mailing Address - Fax:775-355-7522
Practice Address - Street 1:670 N MCCARRAN BLVD
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-4600
Practice Address - Country:US
Practice Address - Phone:775-358-1317
Practice Address - Fax:775-355-7522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV556152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1649388794OtherNPI
NVV103327Medicare PIN
NV1649388794OtherNPI