Provider Demographics
NPI:1407159130
Name:LEFLER, BRIAN DWAYNE (PA-C)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:DWAYNE
Last Name:LEFLER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 N SANDHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:NV
Mailing Address - Zip Code:89027-4789
Mailing Address - Country:US
Mailing Address - Phone:702-849-0558
Mailing Address - Fax:702-346-2147
Practice Address - Street 1:210 N SANDHILL BLVD
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:NV
Practice Address - Zip Code:89027-4789
Practice Address - Country:US
Practice Address - Phone:702-849-0558
Practice Address - Fax:702-346-2147
Is Sole Proprietor?:No
Enumeration Date:2010-12-20
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPA0205363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
V109617OtherMEDICARE PTAN
NV1407159130Medicaid