Provider Demographics
NPI:1881192490
Name:VEINTE VEINTE LAS VEGAS LLC
Entity Type:Organization
Organization Name:VEINTE VEINTE LAS VEGAS LLC
Other - Org Name:OPTICA VEINTE VEINTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:O
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:LICENSED OPTICIAN
Authorized Official - Phone:702-385-7900
Mailing Address - Street 1:556 N EASTERN AVE STE A
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89101-3453
Mailing Address - Country:US
Mailing Address - Phone:702-385-7900
Mailing Address - Fax:
Practice Address - Street 1:556 N EASTERN AVE STE A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-3453
Practice Address - Country:US
Practice Address - Phone:702-385-7900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-29
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV658156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty