Provider Demographics
NPI:1215474374
Name:CADY, MARIA LISA (OD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:LISA
Last Name:CADY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:M
Other - Middle Name:LISA
Other - Last Name:CADY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:5164 MEADOWOOD MALL CIR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-6711
Mailing Address - Country:US
Mailing Address - Phone:775-825-1707
Mailing Address - Fax:
Practice Address - Street 1:5164 MEADOWOOD MALL CIR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-6711
Practice Address - Country:US
Practice Address - Phone:775-825-1707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-27
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV259152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist