Provider Demographics
NPI:1215559521
Name:GIRISGEN & KOPOLOW OD PC
Entity Type:Organization
Organization Name:GIRISGEN & KOPOLOW OD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/CO-OWNER
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 1:4045 SPENCER ST STE A59
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-9311
Mailing Address - Country:US
Mailing Address - Phone:702-437-5521
Mailing Address - Fax:702-437-5502
Practice Address - Street 1:1000 N GREEN VALLEY PKWY STE 420
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-6172
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:2020-05-08
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty