Provider Demographics
NPI:1477725026
Name:TLC RHEUMATOLOGY
Entity Type:Organization
Organization Name:TLC RHEUMATOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:CHAVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-885-2099
Mailing Address - Street 1:896 W NYE LN
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-1544
Mailing Address - Country:US
Mailing Address - Phone:775-885-2099
Mailing Address - Fax:775-885-2288
Practice Address - Street 1:896 W NYE LN
Practice Address - Street 2:SUITE 204
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-1544
Practice Address - Country:US
Practice Address - Phone:775-885-2099
Practice Address - Fax:775-885-2288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-24
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8361174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV39234Medicare PIN
NVF34431Medicare UPIN