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General NPI Number Information
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NPI Number | 1902422181
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Entity Type | Organization
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Legal Business Name | ASPIRE MD PLLC
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Dates
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Enumeration Date | 06/23/2020
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Last Update Date | 09/25/2020
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Provider Practice Location Address
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Address Line | 1930 VILLAGE CENTER CIR # 3-389
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City | LAS VEGAS
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State | NV
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Zip | 89134-6299
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Country | US
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Telephone | 702-800-5886
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Fax | 866-340-7475
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Provider Business Mailing Address
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Address Line | 653 N TOWN CENTER DR STE 204
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City | LAS VEGAS
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State | NV
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Zip | 89144-0516
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Country | US
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Telephone | 702-800-5886
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Fax | 866-340-7475
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Authorized Official
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Title or Position | MANAGER
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Name | AMANDA GROOMS
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Credential |
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Telephone | 702-800-5886
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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