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General NPI Number Information
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NPI Number | 1427382415
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Entity Type | Organization
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Legal Business Name | GIRISGEN & KOPOLOW OD, PC
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Dates
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Enumeration Date | 09/24/2009
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Last Update Date | 09/27/2011
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Provider Practice Location Address
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Address Line | 8145 W SAHARA AVE STE 510
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City | LAS VEGAS
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State | NV
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Zip | 89117-1995
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Country | US
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Telephone | 702-733-6764
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Fax | 702-255-5795
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Provider Business Mailing Address
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Address Line | 7361 W LAKE MEAD BLVD STE 104
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City | LAS VEGAS
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State | NV
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Zip | 89128-1040
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Country | US
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Telephone | 702-733-6764
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Fax | 702-255-5795
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Authorized Official
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Title or Position | OWNER/OPTOMETRIST
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Name | DR. SEFIR T GIRISGEN
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Credential | OD
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Telephone | 702-733-6764
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 323
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License Number State | NV
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