Healthcare Provider Details

I. General information

NPI: 1285668319
Provider Name (Legal Business Name): THOMAS W UMBACH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3235 E WARM SPRINGS RD
LAS VEGAS NV
89120-3187
US

IV. Provider business mailing address

2657 WINDMILL PKWY # 344
HENDERSON NV
89074-3384
US

V. Phone/Fax

Practice location:
  • Phone: 702-463-3300
  • Fax:
Mailing address:
  • Phone: 702-463-3300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number12712
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number12712
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: