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General NPI Number Information
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NPI Number | 1487817110
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Entity Type | Individual
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Provider Name | BEENA THOMAS PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/02/2008
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Last Update Date | 08/13/2014
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Provider Practice Location Address
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Address Line | 10410 S EASTERN AVE SUITE 100
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City | HENDERSON
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State | NV
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Zip | 89052-4195
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Country | US
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Telephone | 702-914-7150
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Fax | 702-492-1728
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Provider Business Mailing Address
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Address Line | PO BOX 98820
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City | LAS VEGAS
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State | NV
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Zip | 89193-8820
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Country | US
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Telephone | 702-914-7150
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Fax | 702-492-1728
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA725
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License Number State | NV
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