MEDICARE: MYLES ADAMSON

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	363LF0000X	Family Nurse Practitioner	AP126755	TX

General Provider Information

NPI Number	:	1962807677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MYLES ADAMSON

Provider Business Mailing Address
First Line	:	818 N 4TH ST
Second Line	:
City	:	LONGVIEW
State	:	TX
Zip	:	75601-5433
Country	:	US
Telephone Number	:	903-236-8600
Fax Number	:

Provider Business Practice Location Address
First Line	:	4040 N MARTIN L KING BLVD STE A
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-3205
Country	:	US
Telephone Number	:	702-644-4673
Fax Number	:	702-902-5443

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2014
Last Update Date	:	11/25/2024

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