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General NPI Number Information
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NPI Number | 1700078037
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Entity Type | Individual
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Provider Name | THOMAS NEIL CARMENA M,D.
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Gender | Male
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Dates
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Enumeration Date | 08/10/2007
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Last Update Date | 08/10/2007
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Provider Practice Location Address
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Address Line | 2250 S RANCHO DR SUITE 225
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City | LAS VEGAS
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State | NV
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Zip | 89102-4451
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Country | US
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Telephone | 702-878-8108
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Fax | 702-878-8108
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Provider Business Mailing Address
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Address Line | 2825 PINTO LN
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City | LAS VEGAS
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State | NV
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Zip | 89107-4618
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Country | US
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Telephone | 702-878-8108
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Fax | 702-878-8108
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 2030
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License Number State | NV
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