Healthcare Provider Details

I. General information

NPI: 1902883341
Provider Name (Legal Business Name): HEALTHCARE PARTNERS MEDICAL GROUP (COATS) LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 03/23/2021
Certification Date: 03/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 N TENAYA WAY STE 301
LAS VEGAS NV
89128
US

IV. Provider business mailing address

PO BOX 98978
LAS VEGAS NV
89193
US

V. Phone/Fax

Practice location:
  • Phone: 702-870-2099
  • Fax: 702-869-5347
Mailing address:
  • Phone: 702-216-3346
  • Fax: 702-671-6883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: H BARD COATS
Title or Position: PRESIDENT
Credential: MD
Phone: 702-216-3346