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General NPI Number Information
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NPI Number | 1528304458
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Entity Type | Organization
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Legal Business Name | GAMMOH PREMIER VISION LLC
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Dates
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Enumeration Date | 12/20/2012
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 556 N EASTERN AVE STE A
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City | LAS VEGAS
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State | NV
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Zip | 89101-3453
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Country | US
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Telephone | 702-840-2020
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Fax | 702-385-1116
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Provider Business Mailing Address
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Address Line | 556 N EASTERN AVE STE A
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City | LAS VEGAS
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State | NV
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Zip | 89101-3453
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Country | US
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Telephone | 702-388-9400
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Fax | 702-385-1116
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. NATALY GAMMOH
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Credential | OD
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Telephone | 702-624-3002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 716
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License Number State | NV
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