Provider Demographics
NPI:1508054719
Name:PEREZ, LARRY CIPRIAN (OD)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:CIPRIAN
Last Name:PEREZ
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7290 ARROYO CROSSING PKWY
Mailing Address - Street 2:#160
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113
Mailing Address - Country:US
Mailing Address - Phone:702-451-3937
Mailing Address - Fax:702-451-2010
Practice Address - Street 1:7290 ARROYO CROSSING PKWY
Practice Address - Street 2:#160
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113
Practice Address - Country:US
Practice Address - Phone:702-451-3937
Practice Address - Fax:702-451-2010
Is Sole Proprietor?:No
Enumeration Date:2007-10-12
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2623152W00000X
NV616152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist