Provider Demographics
NPI:1164299244
Name:TALACTAC, ELAR ARGAO
Entity Type:Individual
Prefix:
First Name:ELAR
Middle Name:ARGAO
Last Name:TALACTAC
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2235 E FLAMINGO RD STE 144
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-0806
Mailing Address - Country:US
Mailing Address - Phone:702-268-7827
Mailing Address - Fax:702-718-0342
Practice Address - Street 1:6656 PROSPECT CLAIM CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89108-6808
Practice Address - Country:US
Practice Address - Phone:702-373-5656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-07
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant