MEDICARE: SKY POINTE HEALTHCARE LTD

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	363AM0700X	Medical Physician Assistant	PA742	NV

General Provider Information

NPI Number	:	1336382894
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SKY POINTE HEALTHCARE LTD

Provider Business Mailing Address
First Line	:	7817 LONESOME HARBOR AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-5002
Country	:	US
Telephone Number	:	702-526-3811
Fax Number	:

Provider Business Practice Location Address
First Line	:	6151 VEGAS DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89108-2593
Country	:	US
Telephone Number	:	702-526-3811
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TAMMY D ROE
Credential	:	PA - C
Telephone Number	:	702-860-9179

Provider Enumeration Date	:	04/14/2009
Last Update Date	:	02/06/2024

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