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General NPI Number Information
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NPI Number | 1306051701
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Entity Type | Organization
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Legal Business Name | PEARLE VISION EXPRESS
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7111 MARVIN D LOVE FWY
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City | DALLAS
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State | TX
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Zip | 75237-3106
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Country | US
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Telephone | 972-298-1454
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Fax |
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Provider Business Mailing Address
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Address Line | 7111 MARVIN D LOVE FWY
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City | DALLAS
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State | TX
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Zip | 75237-3106
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Country | US
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Telephone | 972-298-1454
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALEX TREPETIN
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Credential |
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Telephone | 972-298-1454
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 17822
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License Number State | CA
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