Healthcare Provider Details

I. General information

NPI: 1710558960
Provider Name (Legal Business Name): ANGELA Y ESCALERA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2021
Last Update Date: 07/08/2021
Certification Date: 07/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9159 W FLAMINGO RD STE 103
LAS VEGAS NV
89147-6454
US

IV. Provider business mailing address

9159 W FLAMINGO RD STE 103
LAS VEGAS NV
89147-6454
US

V. Phone/Fax

Practice location:
  • Phone: 702-265-1100
  • Fax:
Mailing address:
  • Phone: 702-265-1100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: