Healthcare Provider Details

I. General information

NPI: 1467757179
Provider Name (Legal Business Name): ALAIN LLANES QBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2011
Last Update Date: 06/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3430 E FLAMINGO RD SUITE 220
LAS VEGAS NV
89121-5003
US

IV. Provider business mailing address

1350 E FLAMINGO RD BOX 577
LAS VEGAS NV
89119-5263
US

V. Phone/Fax

Practice location:
  • Phone: 702-202-2902
  • Fax: 702-202-6551
Mailing address:
  • Phone: 702-202-2902
  • Fax: 702-202-6551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: