Provider Demographics
NPI:1215468582
Name:STEVEN E. GRANT OD PC
Entity type:Organization
Organization Name:STEVEN E. GRANT OD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-564-7581
Mailing Address - Street 1:70 E HORIZON RIDGE PKWY STE 160
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89002-7937
Mailing Address - Country:US
Mailing Address - Phone:702-564-7581
Mailing Address - Fax:
Practice Address - Street 1:70 E HORIZON RIDGE PKWY STE 160
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89002-7937
Practice Address - Country:US
Practice Address - Phone:702-564-7581
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-27
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV#272152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty