Healthcare Provider Details

I. General information

NPI: 1508366204
Provider Name (Legal Business Name): FELIX ESCOBAR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/19/2018
Last Update Date: 06/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4350 ARVILLE ST STE 40
LAS VEGAS NV
89103-3811
US

IV. Provider business mailing address

1522 CAYUGA PKWY
LAS VEGAS NV
89169-3166
US

V. Phone/Fax

Practice location:
  • Phone: 702-202-3184
  • Fax: 702-202-3587
Mailing address:
  • Phone: 702-202-3134
  • Fax: 702-202-3587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: