Provider Demographics
NPI:1144410150
Name:MARIA A STANLEY O D INC
Entity type:Organization
Organization Name:MARIA A STANLEY O D INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:ARRATE
Authorized Official - Last Name:STANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:775-358-7921
Mailing Address - Street 1:2261 PYRAMID WAY
Mailing Address - Street 2:SUITE 5
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-2189
Mailing Address - Country:US
Mailing Address - Phone:775-358-7921
Mailing Address - Fax:775-358-6278
Practice Address - Street 1:2261 PYRAMID WAY
Practice Address - Street 2:SUITE 5
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-2189
Practice Address - Country:US
Practice Address - Phone:775-358-7921
Practice Address - Fax:775-358-6278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-26
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV312152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2516009Medicaid
NV410049750OtherRAILROAD MEDICARE
NVV37314Medicare PIN
NV2516009Medicaid
NV4725180001Medicare NSC