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General NPI Number Information
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NPI Number | 1679706790
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Entity Type | Organization
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Legal Business Name | DIGESTIVE DISEASE CENTER-GREEN VALLEY
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Dates
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Enumeration Date | 08/25/2009
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 1647 E WINDMILL LN STE 110
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City | LAS VEGAS
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State | NV
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Zip | 89123-1908
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Country | US
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Telephone | 702-628-5830
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Fax | 702-270-8984
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Provider Business Mailing Address
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Address Line | 2657 WINDMILL PKWY PMB 347
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City | HENDERSON
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State | NV
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Zip | 89074-3384
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Country | US
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Telephone | 702-628-5230
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Fax | 702-270-8984
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | CYNTHIA J REYES
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Credential |
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Telephone | 702-760-7292
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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 | 2000772.650
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License Number State | NV
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