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General NPI Number Information
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NPI Number | 1174037709
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Entity Type | Organization
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Legal Business Name | HEATHER GAMEZ LLC
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Dates
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Enumeration Date | 11/17/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 3001 SAINT ROSE PKWY
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City | HENDERSON
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State | NV
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Zip | 89052-3839
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Country | US
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Telephone | 702-616-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 2654 W HORIZON RIDGE PKWY
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City | HENDERSON
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State | NV
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Zip | 89052-2803
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CERTIFIED SURGICAL FIRST ASSISTANT
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Name | MS. HEATHER GAMEZ
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Credential | CSFA
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Telephone | 702-574-2114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 171138
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License Number State | NV
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