Provider Demographics
NPI:1932326717
Name:MARGITZA, LOUIS RUSSELL (OD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:RUSSELL
Last Name:MARGITZA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7175 SPRING MOUNTAIN RD
Mailing Address - Street 2:SUITE #1
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-3819
Mailing Address - Country:US
Mailing Address - Phone:702-212-7757
Mailing Address - Fax:702-212-5823
Practice Address - Street 1:7175 SPRING MOUNTAIN RD
Practice Address - Street 2:SUITE #1
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-3819
Practice Address - Country:US
Practice Address - Phone:702-212-7757
Practice Address - Fax:702-212-5823
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2015-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV275152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVU5014Medicare UPIN
NVV38809Medicare ID - Type Unspecified