Provider Demographics
NPI:1558353912
Name:COX, GRANT DAVID (OD)
Entity Type:Individual
Prefix:DR
First Name:GRANT
Middle Name:DAVID
Last Name:COX
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:5741 S PEARL ST
Mailing Address - Street 2:SUITE 25
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-2509
Mailing Address - Country:US
Mailing Address - Phone:170-259-5887
Mailing Address - Fax:
Practice Address - Street 1:3430 E TROPICANA AVE
Practice Address - Street 2:SUITE 25
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-7335
Practice Address - Country:US
Practice Address - Phone:702-458-8500
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-22
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV156152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist