Healthcare Provider Details

I. General information

NPI: 1013980580
Provider Name (Legal Business Name): THOMAS C YEE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 09/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1921 REALEZA CT STE. 200
LAS VEGAS NV
89102-2062
US

IV. Provider business mailing address

1921 REALEZA COURT
LAS VEGAS NV
89102-6017
US

V. Phone/Fax

Practice location:
  • Phone: 702-562-3590
  • Fax: 702-252-8826
Mailing address:
  • Phone: 702-813-3888
  • Fax: 702-252-8826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number6769
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: