Provider Demographics
NPI:1265490205
Name:ISLAS, ARTHUR ANTHONY (MD)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:ANTHONY
Last Name:ISLAS
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 1:401 W. 2ND ST.
Mailing Address - Street 2:#235D / NELSON BLDG / MS 353
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503
Mailing Address - Country:US
Mailing Address - Phone:775-682-8175
Mailing Address - Fax:775-327-2006
Practice Address - Street 1:123 17TH ST.
Practice Address - Street 2:MS 316
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89557
Practice Address - Country:US
Practice Address - Phone:775-784-1533
Practice Address - Fax:775-784-8075
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2341207Q00000X, 207QS0010X
NV15834207Q00000X, 207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX144126301Medicaid
TX8G9680OtherBCBS OF TEXAS
TX8G9680OtherBCBS OF TEXAS
TX8A0834Medicare ID - Type Unspecified
TX144126301Medicaid