Provider Demographics
NPI:1376132209
Name:UMBACH GROUP PRACTICE PLLC
Entity Type:Organization
Organization Name:UMBACH GROUP PRACTICE PLLC
Other - Org Name:ANDREW PHILLIPS ROGERS MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:W
Authorized Official - Last Name:UMBACH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-463-3300
Mailing Address - Street 1:2657 WINDMILL PKWY # 344
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-3384
Mailing Address - Country:US
Mailing Address - Phone:888-531-9625
Mailing Address - Fax:
Practice Address - Street 1:3235 E WARM SPRINGS RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3187
Practice Address - Country:US
Practice Address - Phone:888-531-9625
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-14
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty