Basic Information
Provider Information
NPI: 1427539535
EntityType: 2
ReplacementNPI:  
OrganizationName: VISION CONSULTANTS
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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Mailing Information
Address1: 10580 N MCCARRAN BLVD STE 115-255
Address2:  
City: RENO
State: NV
PostalCode: 895032059
CountryCode: US
TelephoneNumber: 7753758869
FaxNumber:  
Practice Location
Address1: 1950 BARING BLVD
Address2:  
City: SPARKS
State: NV
PostalCode: 89434
CountryCode: US
TelephoneNumber: 7756262224
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/27/2018
LastUpdateDate: 10/15/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: FALDOWSKI
AuthorizedOfficialFirstName: GREGORY
AuthorizedOfficialMiddleName: J
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 7609202920
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: O.D.
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
152W00000X896NVY193400000X SINGLE SPECIALTY GROUPEye and Vision Services ProvidersOptometrist 

No ID Information.


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