| NPI | 1508630542 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OSMEL VILLAREAL Director Of Business Operations 702-000-0000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 163WP0000X Registered Nurse, Pain Management |
| 208VP0000X | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2023-11-09 |
| Last Update Date | 2025-08-26 |