Provider Demographics
NPI:1598808511
Name:NEVADA STATE OPTICAL, INC.
Entity Type:Organization
Organization Name:NEVADA STATE OPTICAL, INC.
Other - Org Name:PEARLE VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FRANCHISE OWNTER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-829-9393
Mailing Address - Street 1:5595 S VIRGINIA ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-6085
Mailing Address - Country:US
Mailing Address - Phone:775-829-9393
Mailing Address - Fax:775-829-9391
Practice Address - Street 1:5595 S VIRGINIA ST
Practice Address - Street 2:SUITE B
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-6085
Practice Address - Country:US
Practice Address - Phone:775-829-9393
Practice Address - Fax:775-829-9391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV239156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty