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General NPI Number Information
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NPI Number | 1588062400
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Entity Type | Organization
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Legal Business Name | EAR NOSE AND THROAT SURGERY CENTER LLC
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Dates
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Enumeration Date | 12/09/2014
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Last Update Date | 05/22/2015
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Provider Practice Location Address
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Address Line | 8840 W. SUNSET RD SUITE B
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City | LAS VEGAS
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State | NV
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Zip | 89148-4897
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Country | US
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Telephone | 702-209-3377
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Fax |
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Provider Business Mailing Address
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Address Line | 8840 W. SUNSET RD. SUITE B
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City | LAS VEGAS
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State | NV
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Zip | 89148-4897
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Country | US
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Telephone | 702-209-3377
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | THOMAS F MEAGHER
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Credential | RN
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Telephone | 702-209-3377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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