MEDICARE: GEM OPTICAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	156FX1800X	Optician	145	NV
2	332H00000X	Eyewear Supplier		NV

General Provider Information

NPI Number	:	1063568103
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GEM OPTICAL

Provider Business Mailing Address
First Line	:	3300 E FLAMINGO RD
Second Line	:	SUITE 20
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-4398
Country	:	US
Telephone Number	:	702-434-9919
Fax Number	:

Provider Business Practice Location Address
First Line	:	3300 E FLAMINGO RD
Second Line	:	SUITE 20
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-4398
Country	:	US
Telephone Number	:	702-434-9919
Fax Number	:

Authorized Official
Title or Position	:	OPTICAIN
Name	:	SHARON TERRELL
Credential	:
Telephone Number	:	702-434-9919

Provider Enumeration Date	:	01/25/2007
Last Update Date	:	09/11/2025

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Directions to “GEM OPTICAL ” Practice Location

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