Healthcare Provider Details

I. General information

NPI: 1427973460
Provider Name (Legal Business Name): CHARLES ALBERT PACHAS JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

737 BARNEGAT BAY ST
HENDERSON NV
89052-5205
US

IV. Provider business mailing address

737 BARNEGAT BAY ST
HENDERSON NV
89052-5205
US

V. Phone/Fax

Practice location:
  • Phone: 702-501-5130
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number12940
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: