Provider Demographics
NPI:1346389285
Name:ALEKSIC, PAUL M (PHD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:M
Last Name:ALEKSIC
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 S. INDUSTRIAL ROAD, SUITE 110
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102
Mailing Address - Country:US
Mailing Address - Phone:702-380-8200
Mailing Address - Fax:702-380-3220
Practice Address - Street 1:1800 S. INDUSTRIAL ROAD, SUITE 110
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102
Practice Address - Country:US
Practice Address - Phone:702-380-8200
Practice Address - Fax:702-380-3220
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPTO468103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV151220AMedicare ID - Type UnspecifiedPROVIDER NUMBER
NVR34159Medicare UPIN