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General NPI Number Information
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NPI Number | 1164626198
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Entity Type | Organization
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Legal Business Name | JESUS F. TIRAO, M.D. LTD
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Dates
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Enumeration Date | 06/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3585 S EASTERN AVE
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City | LAS VEGAS
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State | NV
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Zip | 89169-3344
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Country | US
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Telephone | 702-733-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 3585 S EASTERN AVE
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City | LAS VEGAS
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State | NV
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Zip | 89169-3344
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Country | US
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Telephone | 702-733-9000
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Fax |
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Authorized Official
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Title or Position | FAMILY PRACTICE
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Name | DR. JESUS F TIRAO
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Credential | M.D.
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Telephone | 702-733-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 7757
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License Number State | NV
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