Provider Demographics
NPI:1609944057
Name:PRIESMEYER OPTICAL LLS
Entity Type:Organization
Organization Name:PRIESMEYER OPTICAL LLS
Other - Org Name:PEARLE VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:PRIESMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-965-3937
Mailing Address - Street 1:10742 SUNSET HILLS PLZ
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63127-1207
Mailing Address - Country:US
Mailing Address - Phone:314-965-3937
Mailing Address - Fax:314-800-9000
Practice Address - Street 1:10742 SUNSET HILLS PLZ
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63127-1207
Practice Address - Country:US
Practice Address - Phone:314-965-3937
Practice Address - Fax:314-800-9000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOMO06072OtherVBA PROVIDER NUMBER
MO222991OtherEYEMEDCOLE PROVIDER NUMB
MOPO27215OtherSPECTERA PROVIDER NUMBER
MO52975OtherDAVIS VISION