MEDICARE: TAPIA MEDICAL SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1174380612
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAPIA MEDICAL SERVICES LLC

Provider Business Mailing Address
First Line	:	8640 STONE HARBOR AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89145-5714
Country	:	US
Telephone Number	:	575-649-2344
Fax Number	:	702-745-0990

Provider Business Practice Location Address
First Line	:	8640 STONE HARBOR AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89145-5714
Country	:	US
Telephone Number	:	575-649-2344
Fax Number	:	702-745-0990

Authorized Official
Title or Position	:	OWNER
Name	:	VANESSA MARIE TAPIA
Credential	:	DNP
Telephone Number	:	575-649-2344

Provider Enumeration Date	:	03/01/2024
Last Update Date	:	03/01/2024

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