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General NPI Number Information
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NPI Number | 1023071180
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Entity Type | Organization
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Legal Business Name | SAHARA OUTPATIENT SURGERY CENTER LTD
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Dates
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Enumeration Date | 04/10/2006
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Last Update Date | 02/15/2018
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Provider Practice Location Address
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Address Line | 2401 PASEO DEL PRADO
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City | LAS VEGAS
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State | NV
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Zip | 89102-4363
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Country | US
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Telephone | 702-362-7874
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Fax | 702-362-3567
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Provider Business Mailing Address
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Address Line | 2401 PASEO DEL PRADO
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City | LAS VEGAS
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State | NV
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Zip | 89102-4363
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Country | US
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Telephone | 702-362-7874
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Fax | 702-362-3567
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Authorized Official
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Title or Position | VP
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Name | WILLIAM GREGORY SWINNEY
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Credential |
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Telephone | 972-789-2877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 466ASC10
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License Number State | NV
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