Provider Demographics
NPI:1093411431
Name:GICHERU LASER CENTER CORP
Entity Type:Organization
Organization Name:GICHERU LASER CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SIDNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GICHERU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-574-9600
Mailing Address - Street 1:4708 DEXTER DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5288
Mailing Address - Country:US
Mailing Address - Phone:214-574-9600
Mailing Address - Fax:
Practice Address - Street 1:4708 DEXTER DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5288
Practice Address - Country:US
Practice Address - Phone:214-574-9600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-07
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery