Provider Demographics
NPI:1043486814
Name:NEVADA EYEPA
Entity type:Organization
Organization Name:NEVADA EYEPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MANTHEI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-492-6928
Mailing Address - Street 1:2598 WINDMILL PKWY
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-5476
Mailing Address - Country:US
Mailing Address - Phone:702-492-6928
Mailing Address - Fax:
Practice Address - Street 1:2598 WINDMILL PKWY
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-5476
Practice Address - Country:US
Practice Address - Phone:702-492-6928
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty