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General NPI Number Information
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NPI Number | 1073621512
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Entity Type | Organization
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Legal Business Name | DIGESTIVE DISEASE CENTER
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 2136 E DESERT INN RD STE B
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City | LAS VEGAS
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State | NV
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Zip | 89169-3247
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Country | US
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Telephone | 702-734-0505
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Fax | 702-734-3912
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Provider Business Mailing Address
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Address Line | 2657 WINDMILL PKWY
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City | HENDERSON
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State | NV
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Zip | 89074-3384
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Country | US
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Telephone | 702-734-0505
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Fax | 702-734-3912
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | CYNTHIA J REYES
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Credential |
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Telephone | 702-760-7292
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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 | 469ASC-8
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License Number State | NV
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