Provider Demographics
NPI:1033245949
Name:CENTER FOR CHILDREN'S SURGERY
Entity Type:Organization
Organization Name:CENTER FOR CHILDREN'S SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:TROY
Authorized Official - Middle Name:
Authorized Official - Last Name:REYNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-650-2500
Mailing Address - Street 1:3121 S MARYLAND PKWY
Mailing Address - Street 2:SUITE 400
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89109-2307
Mailing Address - Country:US
Mailing Address - Phone:702-650-2500
Mailing Address - Fax:702-650-2220
Practice Address - Street 1:3121 S MARYLAND PKWY
Practice Address - Street 2:SUITE 400
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-2307
Practice Address - Country:US
Practice Address - Phone:702-650-2500
Practice Address - Fax:702-650-2220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV65812086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1962401893OtherNPI
NV1588664437OtherNPI
NV1659371581OtherNPI
NV1881694719OtherNPI