Provider Demographics
NPI:1407453186
Name:HIGH COTTON LLC
Entity Type:Organization
Organization Name:HIGH COTTON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MAYRA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAIDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-782-3726
Mailing Address - Street 1:7995 BLUE DIAMOND RD STE 102-356
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89178-9301
Mailing Address - Country:US
Mailing Address - Phone:833-782-3726
Mailing Address - Fax:833-296-2176
Practice Address - Street 1:7995 BLUE DIAMOND RD STE 102-356
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89178-9301
Practice Address - Country:US
Practice Address - Phone:833-782-3726
Practice Address - Fax:833-296-2176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-06
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty