MEDICARE: OPTIC GALLERY CENTENNIAL INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	632	NV

General Provider Information

NPI Number	:	1992123244
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTIC GALLERY CENTENNIAL INC

Provider Business Mailing Address
First Line	:	5705 CENTENNIAL CENTER BLVD
Second Line	:	SUITE 150
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-7128
Country	:	US
Telephone Number	:	702-868-2020
Fax Number	:	702-655-2050

Provider Business Practice Location Address
First Line	:	5705 CENTENNIAL CENTER BLVD
Second Line	:	SUITE 150
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-7128
Country	:	US
Telephone Number	:	702-868-2020
Fax Number	:	702-655-2050

Authorized Official
Title or Position	:	MANAGER
Name	:	JESSICA ROSE CLYMER
Credential	:
Telephone Number	:	702-868-2020

Provider Enumeration Date	:	04/03/2014
Last Update Date	:	01/30/2015

Similar Medicare Providers

1336226356 — DR. TODD A HARTMAN O.D.
Practice Location Address:

5705 CENTENNIAL CENTER BLVD , SUITE 150
LAS VEGAS, NV
89149-7128

Practice Phone: 702-868-2020
Practice Fax: 702-655-2050

1467421834 — MR. JEREMY BRENT HAAS M.S., ATC/LAT, CSCS
Practice Location Address:

6480 W FLAMINGO RD , SUITE B
LAS VEGAS, NV
89103-7128

Practice Phone: 702-251-9009
Practice Fax: 702-251-9003

1215221866 — MOBILE MENTALHEALTH SUPPORT SERVICES, INC.
Practice Location Address:

406 S 11TH ST , APT 9
LAS VEGAS, NV
89101-7128

Practice Phone: 818-641-9856
Practice Fax:

1871836718 — MELISSA MILLWEE
Practice Location Address:

10058 SWIMMING HOLE ST
LAS VEGAS, NV
89183-7128

Practice Phone: 702-325-1892
Practice Fax:

1770411886 — RICHARD LEE KIM JR.
Practice Location Address:

5550 PAINTED MIRAGE RD STE 380
LAS VEGAS, NV
89149-4727

Practice Phone: 702-673-7796
Practice Fax:

1790613115 — RISE RESOURCE CENTER LLC
Practice Location Address:

6955 N DURANGO DR
LAS VEGAS, NV
89149-4485

Practice Phone: 702-885-1441
Practice Fax:

Directions to “OPTIC GALLERY CENTENNIAL INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.