Healthcare Provider Details

I. General information

NPI: 1306740659
Provider Name (Legal Business Name): UNIVERSITY MEDICAL CENTER OF SOUTHERN NEVADA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10195 W TWAIN AVE
LAS VEGAS NV
89147-6726
US

IV. Provider business mailing address

1800 W CHARLESTON BLVD
LAS VEGAS NV
89102-2329
US

V. Phone/Fax

Practice location:
  • Phone: 702-383-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: WILLIAM VAN HOUWELING
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 702-383-2000