MEDICARE: MARLEN CHAVEZ MEJIAS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	106S00000X	Behavior Technician	NV
2	363AM0700X	Medical Physician Assistant	NV
3	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1811758485
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARLEN CHAVEZ MEJIAS

Provider Business Mailing Address
First Line	:	2121 E FLAMINGO RD STE 218
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5124
Country	:	US
Telephone Number	:	702-723-0303
Fax Number	:	702-723-0303

Provider Business Practice Location Address
First Line	:	4510 E NEW YORK AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-5636
Country	:	US
Telephone Number	:	702-343-7590
Fax Number	:

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

Provider Enumeration Date	:	01/19/2024
Last Update Date	:	12/03/2025

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Directions to “ MARLEN CHAVEZ MEJIAS ” Practice Location

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