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NPI Code Detail

MEDICARE: CLEMENTE VARGAS III

MEDICARE: CLEMENTE VARGAS III
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1891233086
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLEMENTE VARGAS III
Provider Business Mailing Address
First Line : 400 S 4TH ST
Second Line : SUITE 500
City : LAS VEGAS
State : NV
Zip : 89101-6201
Country : US
Telephone Number : 702-788-5578
Fax Number : 702-793-4037
Provider Business Practice Location Address
First Line : 400 S 4TH ST
Second Line : SUITE 500
City : LAS VEGAS
State : NV
Zip : 89101-6201
Country : US
Telephone Number : 702-788-5578
Fax Number : 702-793-4037
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2017
Last Update Date : 02/07/2017

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Directions to “ CLEMENTE VARGAS III ” Practice Location

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