Healthcare Provider Details
I. General information
NPI: 1952598112
Provider Name (Legal Business Name): THOMSON K CHEMPLAVIL MD PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/01/2007
Last Update Date: 10/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8965 S PECOS RD STE 11A
HENDERSON NV
89074-7159
US
IV. Provider business mailing address
8965 S PECOS RD SUITE 11-A
HENDERSON NV
89074-7158
US
V. Phone/Fax
- Phone: 702-735-4094
- Fax: 702-735-1994
- Phone: 702-735-4094
- Fax: 702-735-1994
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RS0012X |
| Taxonomy | Sleep Medicine (Internal Medicine) Physician |
| License Number | 93770 |
| License Number State | NV |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | 9370 |
| License Number State | NV |
VIII. Authorized Official
Name: DR.
THOMSON
K
CHEMPLAVIL
Title or Position: PROVIDER
Credential: M.D.
Phone: 702-735-4094