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NPI Code Detail

MEDICARE: MR. LOUIE TAQUIQUI

MEDICARE:  MR. LOUIE  TAQUIQUI
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
1251S00000XCommunity/Behavioral Health AgencyNV2017143936NV

General Provider Information

NPI Number : 1508381435
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. LOUIE TAQUIQUI
Provider Business Mailing Address
First Line : 3566 TUNDRA SWAN ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89122-3501
Country : US
Telephone Number : 702-806-5198
Fax Number :
Provider Business Practice Location Address
First Line : 3566 TUNDRA SWAN ST
Second Line :
City : LAS VEGAS
State : NE
Zip : 89122
Country : US
Telephone Number : 702-806-5198
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2017
Last Update Date : 07/21/2022

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Directions to “ MR. LOUIE TAQUIQUI ” Practice Location

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