Healthcare Provider Details

I. General information

NPI: 1346137908
Provider Name (Legal Business Name): BIGHORN CLINIC OF NEVADA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2025
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2225 E FLAMINGO RD STE 100
LAS VEGAS NV
89119-5126
US

IV. Provider business mailing address

2225 E FLAMINGO RD STE 100
LAS VEGAS NV
89119-5126
US

V. Phone/Fax

Practice location:
  • Phone: 702-462-0969
  • Fax: 702-276-9621
Mailing address:
  • Phone: 702-462-0969
  • Fax: 702-276-9621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL C BRAUNSTEIN
Title or Position: OWNER
Credential: MD
Phone: 702-462-0969