Provider Demographics
NPI:1346787520
Name:ZEUS MEDICAL CENTER LLC
Entity Type:Organization
Organization Name:ZEUS MEDICAL CENTER LLC
Other - Org Name:ZEUS MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HOMER
Authorized Official - Middle Name:C
Authorized Official - Last Name:TUAZON
Authorized Official - Suffix:
Authorized Official - Credentials:APN, FNPC
Authorized Official - Phone:702-444-7744
Mailing Address - Street 1:PO BOX 400546
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89140-0546
Mailing Address - Country:US
Mailing Address - Phone:702-444-7744
Mailing Address - Fax:702-444-7898
Practice Address - Street 1:2920 N GREEN VALLEY PKWY
Practice Address - Street 2:STE 215
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-0406
Practice Address - Country:US
Practice Address - Phone:702-444-7744
Practice Address - Fax:702-444-7898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-25
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN001431363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty