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General NPI Number Information
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NPI Number | 1881466639
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Entity Type | Organization
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Legal Business Name | PECOS MEDICAL GROUP
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Dates
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Enumeration Date | 10/25/2023
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Last Update Date | 02/20/2025
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Provider Practice Location Address
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Address Line | 3235 E WARM SPRINGS RD STE 175
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City | LAS VEGAS
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State | NV
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Zip | 89120-3187
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Country | US
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Telephone | 702-463-3300
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Fax |
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Provider Business Mailing Address
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Address Line | 2657 WINDMILL PKWY # 346
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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 | 877-468-0468
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATIVE DIRECTOR
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Name | DEBBIE S RINKER
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Credential |
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Telephone | 702-802-5215
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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