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General NPI Number Information
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NPI Number | 1275034621
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Entity Type | Organization
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Legal Business Name | FABER III, LTD.
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Dates
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Enumeration Date | 02/21/2018
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Last Update Date | 04/17/2018
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Provider Practice Location Address
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Address Line | 8811 W SAHARA AVE STE 200
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City | LAS VEGAS
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State | NV
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Zip | 89117-4813
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Country | US
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Telephone | 702-333-2627
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Fax |
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Provider Business Mailing Address
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Address Line | 9101 W SAHARA AVE
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City | LAS VEGAS
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State | NV
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Zip | 89117-5772
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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 | PRESIDENT
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Name | JOHN M BOWMAN
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Credential | MD
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Telephone | 702-333-2627
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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