Provider Demographics
NPI:1063089084
Name:GIRISGEN & KOPOLOW OD PC
Entity type:Organization
Organization Name:GIRISGEN & KOPOLOW OD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:T
Authorized Official - Last Name:GIRISGEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-437-5521
Mailing Address - Street 1:2021 N RAINBOW BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-7098
Mailing Address - Country:US
Mailing Address - Phone:702-452-2020
Mailing Address - Fax:702-437-5502
Practice Address - Street 1:9460 W FLAMINGO RD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-5743
Practice Address - Country:US
Practice Address - Phone:702-452-2020
Practice Address - Fax:702-437-5502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty