Provider Demographics
NPI:1962920223
Name:INVISION EYE CENTER
Entity type:Organization
Organization Name:INVISION EYE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:TERRY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:435-705-8467
Mailing Address - Street 1:PO BOX 1048
Mailing Address - Street 2:
Mailing Address - City:CALIENTE
Mailing Address - State:NV
Mailing Address - Zip Code:89008-1048
Mailing Address - Country:US
Mailing Address - Phone:775-726-3911
Mailing Address - Fax:775-726-3922
Practice Address - Street 1:820 NORTH SPRING STREET
Practice Address - Street 2:SUITE D
Practice Address - City:CALIENTE
Practice Address - State:NV
Practice Address - Zip Code:89008-1048
Practice Address - Country:US
Practice Address - Phone:775-726-3911
Practice Address - Fax:775-726-3922
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INVISION EYE CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-09-06
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV271703Medicaid