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General NPI Number Information
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NPI Number | 1952030058
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Entity Type | Organization
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Legal Business Name | ADA I VERA DPM LTD
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Dates
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Enumeration Date | 06/06/2022
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Last Update Date | 06/06/2022
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Provider Practice Location Address
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Address Line | 3000 W CHARLESTON BLVD STE 6
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City | LAS VEGAS
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State | NV
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Zip | 89102-1940
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Country | US
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Telephone | 702-878-5252
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Fax | 702-878-1963
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Provider Business Mailing Address
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Address Line | PO BOX 33250
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City | LAS VEGAS
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State | NV
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Zip | 89133-3250
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Country | US
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Telephone | 702-659-7799
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Fax | 702-659-7805
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Authorized Official
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Title or Position | OWNER
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Name | ADA IRIS VERA
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Credential |
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Telephone | 702-878-5252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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