Provider Demographics
NPI:1225259419
Name:CLEARVISION EYE CENTERS CLARK COUNTY LLP
Entity Type:Organization
Organization Name:CLEARVISION EYE CENTERS CLARK COUNTY LLP
Other - Org Name:CLEAR VISION EYE CENTERS WIGWAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:D
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:702-294-2227
Mailing Address - Street 1:2625 WIGWAM PKWY
Mailing Address - Street 2:STE 108
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7325
Mailing Address - Country:US
Mailing Address - Phone:702-451-1522
Mailing Address - Fax:702-456-1813
Practice Address - Street 1:2625 WIGWAM PKWY
Practice Address - Street 2:STE 108
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7325
Practice Address - Country:US
Practice Address - Phone:702-451-1522
Practice Address - Fax:702-456-1813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV234152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty