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General NPI Number Information
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NPI Number | 1043740442
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Entity Type | Individual
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Provider Name | MR. PAPAREX EDIRIN MINABOWAN
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Gender | Male
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Dates
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Enumeration Date | 06/18/2017
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Last Update Date | 06/18/2017
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Provider Practice Location Address
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Address Line | 1810 E SAHARA AVE # 108
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City | LAS VEGAS
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State | NV
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Zip | 89104-3707
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Country | US
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Telephone | 702-822-0447
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Fax |
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Provider Business Mailing Address
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Address Line | 11000 S EASTERN AVE APT 1325
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City | HENDERSON
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State | NV
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Zip | 89052-2964
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Country | US
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Telephone | 907-764-1035
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number | NV20171341089
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License Number State | NV
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