Healthcare Provider Details
I. General information
NPI: 1164352480
Provider Name (Legal Business Name): ADVANCED VASCULAR ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10561 JEFFREYS ST. SUITE 100
HENDERSON NV
89052-4267
US
IV. Provider business mailing address
9811 W. CHARLESTON BLVD #2640
LAS VEGAS NV
89117-7528
US
V. Phone/Fax
- Phone: 702-565-8346
- Fax: 702-202-2000
- Phone: 702-565-8346
- Fax: 702-202-2000
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0129X |
| Taxonomy | Vascular Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
EDDY
H
LUH
Title or Position: PARTNER/PHYSICIAN
Credential: M.D.
Phone: 702-565-8346