Provider Demographics
NPI:1457663627
Name:MAGLARAS, CHRIS JR
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:
Last Name:MAGLARAS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 E DESERT INN RD
Mailing Address - Street 2:#278
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-3611
Mailing Address - Country:US
Mailing Address - Phone:702-340-1144
Mailing Address - Fax:702-215-6395
Practice Address - Street 1:4863 MONTERREY AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-6812
Practice Address - Country:US
Practice Address - Phone:702-340-1144
Practice Address - Fax:702-215-6395
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-05
Last Update Date:2010-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2000027-424332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies