Provider Demographics
NPI:1366648750
Name:ALAMO-LEON, JULIETA C (OD)
Entity type:Individual
Prefix:DR
First Name:JULIETA
Middle Name:C
Last Name:ALAMO-LEON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:JULIETA
Other - Middle Name:C
Other - Last Name:ALAMO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:8880 W. CHARLESTON BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-5454
Mailing Address - Country:US
Mailing Address - Phone:702-938-2020
Mailing Address - Fax:702-938-2034
Practice Address - Street 1:8880 W. CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-5454
Practice Address - Country:US
Practice Address - Phone:702-938-2020
Practice Address - Fax:702-938-2024
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-22
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV306152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV880331888OtherEIN