Healthcare Provider Details

I. General information

NPI: 1326736646
Provider Name (Legal Business Name): THE SLEEP CENTER OF NEVADA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2023
Last Update Date: 04/25/2023
Certification Date: 04/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8670 W CHEYENNE AVE STE 220
LAS VEGAS NV
89129-7457
US

IV. Provider business mailing address

5701 W CHARLESTON BLVD STE 208
LAS VEGAS NV
89146-0906
US

V. Phone/Fax

Practice location:
  • Phone: 702-818-2444
  • Fax: 702-818-2440
Mailing address:
  • Phone: 702-818-2444
  • Fax: 702-818-2440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RACHAKONDA D PRABHU
Title or Position: OWNER
Credential: MD
Phone: 702-877-9514