Provider Demographics
NPI:1437770823
Name:PEPICH, GARRETT THOMAS (DO)
Entity Type:Individual
Prefix:DR
First Name:GARRETT
Middle Name:THOMAS
Last Name:PEPICH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10624 S EASTERN AVE # A-955
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-2982
Mailing Address - Country:US
Mailing Address - Phone:702-407-7700
Mailing Address - Fax:702-407-7016
Practice Address - Street 1:10624 S EASTERN AVE # A-955
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-2982
Practice Address - Country:US
Practice Address - Phone:702-407-7700
Practice Address - Fax:702-407-7016
Is Sole Proprietor?:No
Enumeration Date:2020-04-27
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR3341207R00000X
NVDO3421207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine