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NPI Code Detail

MEDICARE: BRIAN VASQUEZ

MEDICARE: BRIAN VASQUEZ
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
1104100000XSocial Worker10793-MNV

General Provider Information

NPI Number : 1588229900
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIAN VASQUEZ
Provider Business Mailing Address
First Line : 5576 S FORT APACHE RD STE 120
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-3607
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5576 S FORT APACHE RD STE 120
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-3607
Country : US
Telephone Number : 702-287-0966
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2019
Last Update Date : 05/28/2024

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Directions to “ BRIAN VASQUEZ ” Practice Location

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