Provider Demographics
NPI:1801077953
Name:DRS. NAGY & POTTER, O.D.
Entity type:Organization
Organization Name:DRS. NAGY & POTTER, O.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:J
Authorized Official - Last Name:POTTER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:559-686-8628
Mailing Address - Street 1:440 E KING AVE
Mailing Address - Street 2:
Mailing Address - City:TULARE
Mailing Address - State:CA
Mailing Address - Zip Code:93274-4223
Mailing Address - Country:US
Mailing Address - Phone:559-686-8628
Mailing Address - Fax:559-686-2507
Practice Address - Street 1:440 E KING AVE
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274-4223
Practice Address - Country:US
Practice Address - Phone:559-686-8628
Practice Address - Fax:559-686-2507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAYYY41591YMedicaid
CAYYY41591YMedicaid
CA0678700001Medicare NSC
CAYYY41591YMedicare PIN