Organization
OPTIC GALLERY SAHARA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER PAEZ O.D (OPTOMETRIST)
(702) 893-3937
Entity
Organization
Contact information
Practice address
2580 S DECATUR BLVD STE 6, LAS VEGAS, NV 89102-5513
(702) 893-3937
(702) 893-3429
Mailing address
2580 S DECATUR BLVD STE 6, LAS VEGAS, NV 89102-5513
(702) 893-3937
(702) 893-3429
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
507
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100506828
—
NV
Enumeration date
11/22/2011
Last updated
11/22/2011
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