Healthcare Provider Details

I. General information

NPI: 1366648750
Provider Name (Legal Business Name): JULIETA C ALAMO-LEON OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JULIETA C ALAMO OD

II. Dates (important events)

Enumeration Date: 06/22/2007
Last Update Date: 11/08/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8880 W. CHARLESTON BLVD
LAS VEGAS NV
89117-5454
US

IV. Provider business mailing address

8880 W. CHARLESTON BLVD
LAS VEGAS NV
89117-5454
US

V. Phone/Fax

Practice location:
  • Phone: 702-938-2020
  • Fax: 702-938-2024
Mailing address:
  • Phone: 702-938-2020
  • Fax: 702-938-2034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number306
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: