Healthcare Provider Details

I. General information

NPI: 1184373003
Provider Name (Legal Business Name): WEKARE MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2022
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3215 W CHARLESTON BLVD STE 110
LAS VEGAS NV
89102-2182
US

IV. Provider business mailing address

3215 W CHARLESTON BLVD STE 110
LAS VEGAS NV
89102-2182
US

V. Phone/Fax

Practice location:
  • Phone: 702-430-7362
  • Fax: 702-935-7624
Mailing address:
  • Phone: 27-430-7362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PHILLIP BLEDSOE
Title or Position: OWNER
Credential:
Phone: 725-577-8636