MEDICARE: CHRIS PROMPRASERT

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	363A00000X	Physician Assistant	PA3406	NV

General Provider Information

NPI Number	:	1396617593
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRIS PROMPRASERT

Provider Business Mailing Address
First Line	:	7385 S PECOS RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3768
Country	:	US
Telephone Number	:	702-796-4278
Fax Number	:	702-734-2650

Provider Business Practice Location Address
First Line	:	7385 S PECOS RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3768
Country	:	US
Telephone Number	:	702-796-4278
Fax Number	:	702-734-2650

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/18/2025
Last Update Date	:	02/02/2026

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Directions to “ CHRIS PROMPRASERT ” Practice Location

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