Individual provider Active NPI

Lawrence-Stuart Miciano Cruz, O.D.

  • Optometrist
  • Fort Worth, TX
National Provider Identifier
1760867246
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11154 Issued in TX
Practice address
1653 River Run Ste 101
Fort Worth, TX 76107-6680
Phone
(817) 727-4555
NPI assigned
Jul 24, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 15353 CA
Optometrist 152W00000X 958 NV
Optometrist 152W00000X OD60589484 WA
Optometrist 152W00000X 11154 TX Primary

Addresses

Primary practice location

1653 River Run Ste 101
Fort Worth, TX 76107-6680

Mailing address

1653 River Run Ste 101
Fort Worth, TX 76107-6680
Phone (817) 727-4555

Other practice location 1

9460 W Flamingo Rd Ste 100
Las Vegas, NV 89147-5743
Phone (702) 452-2020

Other practice location 2

2215 S Loop 288 Ste 334
Denton, TX 76205-4984
Phone (940) 484-7258

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180628002022 NV Practitioner - Optometry 6204128572 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11154TXMDOptometrist
OD60589484WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Girisgen & Kopolow OD, PC Optometrist CurrentSince Jul 1, 2018 Accepting new patients
Kopolow & Girisgen Professional Corporation Optometrist CurrentSince Jul 1, 2018 Accepting new patients
Desert View Regional Medical Center Holdings, LLC Past Accepting new patients
De Craig Ranch, LLC Past Accepting new patients
De Craig Ranch, LLC Past Accepting new patients
North Vista Hospital LLC Past Accepting new patients
Henderson Hospital Past Accepting new patients
Dignity Health Past Accepting new patients
Southern Hills Medical Center, LLC Past Accepting new patients
De Craig Ranch, LLC Past Accepting new patients
Desert Springs Hospital Past Accepting new patients
Dr. James P. Prediger & Associates, Inc Optometrist PastSince Oct 1, 2024 Accepting new patients
Summerlin Hospital Medical Center L L C Past Accepting new patients
De Craig Ranch, LLC Past Accepting new patients
Spring Valley Medical Center Past Accepting new patients
Spring Valley Medical Center Past Accepting new patients
Dignity Health Past Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients
Sunrise Hospital and Medical Center, LLC Past Accepting new patients
Dignity Health Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients

Locations

75 S Valle Verde Dr
Ste 120
Henderson, NV 89012

1000 N Green Valley Pkwy
Ste 420
Henderson, NV 89074
Phone (725) 502-2802

4045 Spencer St
Ste A59
Las Vegas, NV 89119
Phone (702) 437-5521

9460 W Flamingo Rd
Ste 100
Las Vegas, NV 89147

2021 N Rainbow Blvd
Ste 100
Las Vegas, NV 89108
Phone (702) 515-0200

7361 W Lake Mead Blvd
Ste 104
Las Vegas, NV 89128
Phone (702) 341-7254

5465 Meadowood Mall Cir
Reno, NV 89502
Phone (775) 826-4100

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1566/brand/2/csg/41/fhir/r4

Organizations & group practices 22

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 22

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1437696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1760867246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1653 RIVER RUN STE 101",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761076680",
            "telephone_number": "817-727-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1653 RIVER RUN STE 101",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761076680",
            "telephone_number": "817-727-4555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9460 W Flamingo Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891475743",
            "country_code": "US",
            "telephone_number": "702-452-2020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2215 S Loop 288 Ste 334",
            "address_purpose": "LOCATION",
            "city": "Denton",
            "state": "TX",
            "postal_code": "762054984",
            "country_code": "US",
            "telephone_number": "940-484-7258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "LAWRENCE-STUART",
        "middle_name": "MICIANO",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-24",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "15353",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "958",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD60589484",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "11154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.