Healthcare Provider Details

I. General information

NPI: 1629392253
Provider Name (Legal Business Name): DENICE STARLEY, D.O.,P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2010
Last Update Date: 03/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7670 W SAHARA AVE STE 2
LAS VEGAS NV
89117-2751
US

IV. Provider business mailing address

PO BOX 778436
HENDERSON NV
89077-8436
US

V. Phone/Fax

Practice location:
  • Phone: 702-212-3333
  • Fax: 702-212-3300
Mailing address:
  • Phone: 702-622-7983
  • Fax: 702-614-8047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number1334
License Number StateNV

VIII. Authorized Official

Name: DR. DENICE STARLEY
Title or Position: OWNER
Credential: D.O.
Phone: 702-622-7983