Provider Demographics
NPI:1366906976
Name:HENDERSON VISION CARE LLC
Entity type:Organization
Organization Name:HENDERSON VISION CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SPENCER
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINTON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:702-938-0320
Mailing Address - Street 1:305 N PECOS RD STE A
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-1352
Mailing Address - Country:US
Mailing Address - Phone:702-938-0320
Mailing Address - Fax:
Practice Address - Street 1:305 N PECOS RD STE A
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-1352
Practice Address - Country:US
Practice Address - Phone:702-938-0320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-28
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty