| NPI | 1285457143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TILLIE ANDRADE Credentialing Specialist 702-449-9173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 261QS0132X Clinic/Center, Ophthalmologic Surgery |
| Enumeration Date | 2024-11-07 |
| Last Update Date | 2025-01-17 |