=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275988107
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALLIANCE MENTAL HEALTH SPECIALISTS SUBA PARK CHENG PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/28/2016
-----------------------------------------------------
Last Update Date | 10/06/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4270 S DECATUR BLVD STE B6
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89103-6802
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-485-2100
-----------------------------------------------------
Fax | 725-433-8734
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4270 S DECATUR BLVD STE B6
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89103-6802
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-485-2100
-----------------------------------------------------
Fax | 725-433-8734
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | RCM MANAGER
-----------------------------------------------------
Name | SYMON GARRAEZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 720-835-5915
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | 13792
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------