Healthcare Provider Details

I. General information

NPI: 1174320923
Provider Name (Legal Business Name): ALDER NEVADA OCULOPLASTICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2025
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7305 S PECOS RD STE 102
LAS VEGAS NV
89120-3701
US

IV. Provider business mailing address

2850 W HORIZON RIDGE PKWY STE 300
HENDERSON NV
89052-4395
US

V. Phone/Fax

Practice location:
  • Phone: 702-485-5000
  • Fax: 702-485-5001
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: SHELI CRABTREE
Title or Position: SENIOR CREDENTIALING MANAGER
Credential:
Phone: 512-314-1613