Provider Demographics
NPI:1164896908
Name:PEARLE VISION
Entity Type:Organization
Organization Name:PEARLE VISION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:BENNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-428-8612
Mailing Address - Street 1:5408 CREEK ARBOR CT
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-7504
Mailing Address - Country:US
Mailing Address - Phone:972-428-8612
Mailing Address - Fax:
Practice Address - Street 1:8101 GLENVIEW DR
Practice Address - Street 2:
Practice Address - City:N RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-8379
Practice Address - Country:US
Practice Address - Phone:972-428-8612
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-17
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier