Provider Demographics
NPI:1578257820
Name:JONES, ALEXANDRIA SHELBY
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:SHELBY
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7350 W CENTENNIAL PKWY UNIT 3024
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-1673
Mailing Address - Country:US
Mailing Address - Phone:702-290-2474
Mailing Address - Fax:
Practice Address - Street 1:6592 N DECATUR BLVD STE 130
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89131-1039
Practice Address - Country:US
Practice Address - Phone:702-998-8080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-07
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1166152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist