Provider Demographics
NPI:1710699939
Name:PREMIER EYE CENTER PLLC
Entity Type:Organization
Organization Name:PREMIER EYE CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALI NASRALLAH
Authorized Official - Middle Name:
Authorized Official - Last Name:NASRALLAH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:313-244-4444
Mailing Address - Street 1:3554 POLK ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-3836
Mailing Address - Country:US
Mailing Address - Phone:313-244-4444
Mailing Address - Fax:
Practice Address - Street 1:22361 W VILLAGE DR STE 106
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2227
Practice Address - Country:US
Practice Address - Phone:313-244-4444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty