Healthcare Provider Details

I. General information

NPI: 1851551675
Provider Name (Legal Business Name): COMPREHENSIVE ORTHOPEDICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2008
Last Update Date: 08/02/2023
Certification Date: 08/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9151 ESTATE THOMAS SUITE 206 FOOTHILL PROFESSIONAL BLDG.
ST THOMAS VI
00802-2617
US

IV. Provider business mailing address

1887 WHITNEY MESA DR # 9001ZN
HENDERSON NV
89014-2069
US

V. Phone/Fax

Practice location:
  • Phone: 340-779-2663
  • Fax: 340-779-2443
Mailing address:
  • Phone: 855-777-4853
  • Fax: 340-779-2443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number1-6918-1L
License Number StateVI
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateVI

VIII. Authorized Official

Name: MR. BRIAN CARLOS BACOT
Title or Position: SURGEON
Credential: MD
Phone: 340-779-2663