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General NPI Number Information
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NPI Number | 1851103147
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Entity Type | Organization
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Legal Business Name | CHIN MD PLLC
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Dates
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Enumeration Date | 01/23/2025
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 1701 W CHARLESTON BLVD STE 200
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City | LAS VEGAS
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State | NV
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Zip | 89102-2312
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Country | US
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Telephone | 512-846-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 W 38TH ST
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City | AUSTIN
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State | TX
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Zip | 78731-6400
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING
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Name | VERONICA IBANEZ
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Credential |
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Telephone | 432-386-6429
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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