Organization
OPTIC GALLERY SUMMERLIN, INC
Active
Other names
Optic Gallery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WESS MICHAEL JORDAN O.D. (OPTOMETRIST/OWNER)
(702) 654-2020
Entity
Organization
Contact information
Practice address
7560 W LAKE MEAD BLVD STE 2, LAS VEGAS, NV 89128-1050
(702) 654-2020
Mailing address
7560 W LAKE MEAD BLVD STE 2, LAS VEGAS, NV 89128-1050
(702) 654-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45-2765950
OPTOMETRIST/OWNER TAX ID
NV
Enumeration date
12/08/2011
Last updated
01/19/2023
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