Healthcare Provider Details

I. General information

NPI: 1942730650
Provider Name (Legal Business Name): VINCENT ALEXANDER LLAUGER BS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2017
Last Update Date: 06/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 S RANCHO DR STE I62
LAS VEGAS NV
89106-4838
US

IV. Provider business mailing address

501 S RANCHO DR STE I62
LAS VEGAS NV
89106-4838
US

V. Phone/Fax

Practice location:
  • Phone: 702-984-6500
  • Fax: 702-974-4555
Mailing address:
  • Phone: 702-981-1153
  • Fax: 702-974-4555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: