Provider Demographics
NPI:1235621053
Name:CENTER OF SPECIAL PROCEDURES
Entity Type:Organization
Organization Name:CENTER OF SPECIAL PROCEDURES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:S
Authorized Official - Last Name:MUIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-254-3020
Mailing Address - Street 1:653 N TOWN CENTER DR STE 210
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89144-0516
Mailing Address - Country:US
Mailing Address - Phone:702-254-3020
Mailing Address - Fax:
Practice Address - Street 1:653 N TOWN CENTER DR STE 210
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89144-0516
Practice Address - Country:US
Practice Address - Phone:702-254-3020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WILLIAM S MUIR MD LTD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-06-06
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11685174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002084150Medicaid