Provider Demographics
NPI:1245237346
Name:GARETTO, THOMAS PETER (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:PETER
Last Name:GARETTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 81200
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89180-1200
Mailing Address - Country:US
Mailing Address - Phone:702-873-4567
Mailing Address - Fax:702-873-0414
Practice Address - Street 1:2320 PASEO DEL PRADO
Practice Address - Street 2:# B-207
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-4358
Practice Address - Country:US
Practice Address - Phone:702-873-4567
Practice Address - Fax:702-873-0414
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8115207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002002671Medicaid
NV002002671Medicaid