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General NPI Number Information
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NPI Number | 1164073649
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Entity Type | Organization
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Legal Business Name | PEARLE VISION 8391
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Dates
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Enumeration Date | 09/25/2019
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Last Update Date | 09/25/2019
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Provider Practice Location Address
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Address Line | 1681 N CENTRAL EXPY STE 400
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City | MCKINNEY
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State | TX
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Zip | 75070-3140
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Country | US
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Telephone | 972-548-8710
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Fax |
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Provider Business Mailing Address
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Address Line | 1681 N CENTRAL EXPY STE 400
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City | MCKINNEY
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State | TX
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Zip | 75070-3140
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Country | US
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Telephone | 972-548-8710
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Fax |
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Authorized Official
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Title or Position | LICENSED OPERATOR
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Name | MRS. SHIREEN LAKHANI
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Credential |
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Telephone | 972-548-8710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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