MEDICARE: SIRINTR/SUK PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist

General Provider Information

NPI Number	:	1437706934
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIRINTR/SUK PLLC

Provider Business Mailing Address
First Line	:	10999 GAELIC HILLS DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89141-4393
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6085 S FORT APACHE RD STE 120-130
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-5545
Country	:	US
Telephone Number	:	858-204-7724
Fax Number	:

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	DONG SUK
Credential	:	OD
Telephone Number	:	858-204-7724

Provider Enumeration Date	:	08/20/2019
Last Update Date	:	08/20/2019

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