Healthcare Provider Details

I. General information

NPI: 1295959641
Provider Name (Legal Business Name): SUSAN SCHWARTZ DO PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 08/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8985 S PECOS RD STE 3B
HENDERSON NV
89074-7163
US

IV. Provider business mailing address

2911 N RAMPART # 187
LAS VEGAS NV
89128
US

V. Phone/Fax

Practice location:
  • Phone: 702-647-2900
  • Fax: 702-440-6060
Mailing address:
  • Phone: 702-647-2900
  • Fax: 702-440-6060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: SUSAN E SCHWARTZ
Title or Position: PRESIDENT
Credential: DO
Phone: 702-647-2900