Provider Demographics
NPI:1326736646
Name:THE SLEEP CENTER OF NEVADA
Entity Type:Organization
Organization Name:THE SLEEP CENTER OF NEVADA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHAKONDA
Authorized Official - Middle Name:D
Authorized Official - Last Name:PRABHU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-877-9514
Mailing Address - Street 1:5701 W CHARLESTON BLVD STE 208
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-0906
Mailing Address - Country:US
Mailing Address - Phone:702-818-2444
Mailing Address - Fax:702-818-2440
Practice Address - Street 1:8670 W CHEYENNE AVE STE 220
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-7457
Practice Address - Country:US
Practice Address - Phone:702-818-2444
Practice Address - Fax:702-818-2440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty