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General NPI Number Information
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NPI Number | 1770378549
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Entity Type | Individual
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Provider Name | OWEN CLYDE CRUZ RT
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Gender | Male
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Dates
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Enumeration Date | 04/11/2025
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Last Update Date | 04/11/2025
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Provider Practice Location Address
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Address Line | 6070 S FORT APACHE RD STE 110
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City | LAS VEGAS
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State | NV
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Zip | 89148-5615
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Country | US
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Telephone | 702-839-1114
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Fax | 702-380-1081
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Provider Business Mailing Address
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Address Line | 2821 W HORIZON RIDGE PKWY STE 101
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City | HENDERSON
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State | NV
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Zip | 89052-4429
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Country | US
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Telephone | 725-333-7124
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Fax | 702-893-0960
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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 | 227900000X
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Taxonomy Name | Registered Respiratory Therapist
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License Number | 3845
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License Number State | NV
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