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General NPI Number Information
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NPI Number | 1841925849
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Entity Type | Organization
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Legal Business Name | PEARLE CAPSTONE EYE ASSOCIATES, PLLC
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Dates
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Enumeration Date | 07/22/2022
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Last Update Date | 11/11/2022
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Provider Practice Location Address
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Address Line | 13555 FL 54 SUITE C
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City | ODESSA
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State | FL
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Zip | 33556
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Country | US
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Telephone | 813-454-0670
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Fax | 813-730-8090
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Provider Business Mailing Address
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Address Line | 1601 NW EXPRESSWAY STE 1420
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City | OKLAHOMA CITY
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State | OK
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Zip | 73118-1460
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Country | US
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Telephone | 405-438-0345
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Fax | 405-353-6998
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Authorized Official
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Title or Position | AMBR
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Name | ALLISON DICKSON
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Credential | OD
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Telephone | 616-717-1634
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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 |
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License Number State |
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