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General NPI Number Information
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NPI Number | 1841090149
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Entity Type | Organization
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Legal Business Name | LAS VEGAS PEDIATRICS, PLLC
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Dates
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Enumeration Date | 03/17/2025
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 6070 S RAINBOW BLVD STE 10
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City | LAS VEGAS
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State | NV
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Zip | 89118-2503
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Country | US
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Telephone | 702-420-7222
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Fax | 702-331-6018
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Provider Business Mailing Address
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Address Line | 6070 S RAINBOW BLVD STE 10
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City | LAS VEGAS
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State | NV
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Zip | 89118-2503
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Country | US
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Telephone | 702-420-7222
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. MIMI KURIAKOSE
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Credential | MD
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Telephone | 702-420-7222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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