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General NPI Number Information
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NPI Number | 1033245949
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Entity Type | Organization
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Legal Business Name | CENTER FOR CHILDREN'S SURGERY
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3121 S MARYLAND PKWY SUITE 400
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City | LAS VEGAS
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State | NV
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Zip | 89109-2307
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Country | US
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Telephone | 702-650-2500
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Fax | 702-650-2220
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Provider Business Mailing Address
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Address Line | 3121 S MARYLAND PKWY SUITE 400
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City | LAS VEGAS
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State | NV
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Zip | 89109-2307
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Country | US
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Telephone | 702-650-2500
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Fax | 702-650-2220
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Authorized Official
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Title or Position | DOCTOR
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Name | TROY REYNA
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Credential |
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Telephone | 702-650-2500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0120X
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Taxonomy Name | Pediatric Surgery Physician
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License Number | 6581
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License Number State | NV
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