Provider Demographics
NPI:1083821714
Name:EAR, NOSE & THROAT CONSULTANTS OF NEVADA
Entity Type:Organization
Organization Name:EAR, NOSE & THROAT CONSULTANTS OF NEVADA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHROEDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-792-6700
Mailing Address - Street 1:3195 SAINT ROSE PKWY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-3501
Mailing Address - Country:US
Mailing Address - Phone:702-792-6700
Mailing Address - Fax:702-792-7198
Practice Address - Street 1:3195 SAINT ROSE PKWY
Practice Address - Street 2:SUITE 210
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-3501
Practice Address - Country:US
Practice Address - Phone:702-792-6700
Practice Address - Fax:702-792-7198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6110174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVNV4824OtherBCBS GROUP NUMBER
NVVWJBDYOtherMEDICARE INDIVIDUAL CODE
NVVWJBDYOtherMEDICARE INDIVIDUAL CODE