MEDICARE: HENRY J. LOK, DO PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	171100000X	Acupuncturist
2	204D00000X	Neuromusculoskeletal Medicine & OMM Physician
3	207Q00000X	Family Medicine Physician
4	208VP0014X	Interventional Pain Medicine Physician
5	208VP0000X	Pain Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1033501671	OTHER		NPI

General Provider Information

NPI Number	:	1598227985
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HENRY J. LOK, DO PLLC

Provider Business Mailing Address
First Line	:	1818 E DESERT INN RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89169-3209
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1818 E DESERT INN RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89169-3209
Country	:	US
Telephone Number	:	775-391-5998
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	HENRY LOK
Credential	:	MD
Telephone Number	:	702-885-9635

Provider Enumeration Date	:	04/03/2019
Last Update Date	:	06/24/2019

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