Provider Demographics
NPI:1952448144
Name:PEARSON ENTERPRISES INTERNATIONAL LLC
Entity Type:Organization
Organization Name:PEARSON ENTERPRISES INTERNATIONAL LLC
Other - Org Name:ROBERT PEARSON OD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:PEARSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:702-631-4144
Mailing Address - Street 1:6134 W. LAKE MEAD BLVD
Mailing Address - Street 2:E-8
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-2659
Mailing Address - Country:US
Mailing Address - Phone:702-631-4144
Mailing Address - Fax:702-631-9094
Practice Address - Street 1:6134 W. LAKE MEAD BLVD
Practice Address - Street 2:E-8
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89108-2659
Practice Address - Country:US
Practice Address - Phone:702-631-4144
Practice Address - Fax:702-631-9094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV232152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002502009Medicaid
T67322Medicare UPIN
NV002502009Medicaid