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General NPI Number Information
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NPI Number | 1952448144
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Entity Type | Organization
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Legal Business Name | PEARSON ENTERPRISES INTERNATIONAL LLC
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 08/30/2012
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Provider Practice Location Address
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Address Line | 6134 W. LAKE MEAD BLVD E-8
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City | LAS VEGAS
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State | NV
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Zip | 89108-2659
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Country | US
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Telephone | 702-631-4144
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Fax | 702-631-9094
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Provider Business Mailing Address
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Address Line | 6134 W. LAKE MEAD BLVD E-8
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City | LAS VEGAS
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State | NV
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Zip | 89108-2659
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Country | US
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Telephone | 702-631-4144
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Fax | 702-631-9094
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT ALLEN PEARSON
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Credential | O.D.
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Telephone | 702-631-4144
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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 | 232
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License Number State | NV
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