Healthcare Provider Details

I. General information

NPI: 1740446558
Provider Name (Legal Business Name): VAHEY & GLUCK HAND SURGERY, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2008
Last Update Date: 06/29/2020
Certification Date: 06/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8585 S EASTERN AVE SUITE 100
LAS VEGAS NV
89123-2817
US

IV. Provider business mailing address

8585 S EASTERN AVE #100
LAS VEGAS NV
89123-2817
US

V. Phone/Fax

Practice location:
  • Phone: 702-798-8585
  • Fax: 702-341-0109
Mailing address:
  • Phone: 702-798-8585
  • Fax: 702-341-0109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. BO BAUTISTA
Title or Position: OFFICE MANAGER
Credential:
Phone: 702-798-8585