Provider Demographics
NPI:1780998625
Name:INVISION EYE CENTER
Entity type:Organization
Organization Name:INVISION EYE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:TERRY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:775-726-3911
Mailing Address - Street 1:PO BOX 1048
Mailing Address - Street 2:
Mailing Address - City:CALIENTE
Mailing Address - State:NV
Mailing Address - Zip Code:89008-1048
Mailing Address - Country:US
Mailing Address - Phone:775-726-3911
Mailing Address - Fax:775-726-3922
Practice Address - Street 1:820 NORTH SPRING ST
Practice Address - Street 2:STE D
Practice Address - City:CALIENTE
Practice Address - State:NV
Practice Address - Zip Code:89008-1048
Practice Address - Country:US
Practice Address - Phone:775-726-3911
Practice Address - Fax:775-726-3922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-03
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV596152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1780998625Medicaid
6456770001Medicare PIN
DK635AMedicare PIN
DQ5962Medicare PIN