Provider Demographics
NPI:1497432793
Name:NEVADA ALWAYS YOUR DOCTOR LLC.
Entity Type:Organization
Organization Name:NEVADA ALWAYS YOUR DOCTOR LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:SIMPORIOS
Authorized Official - Last Name:MONTECILLO
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:702-826-0959
Mailing Address - Street 1:4580 S EASTERN AVE STE 29
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-6100
Mailing Address - Country:US
Mailing Address - Phone:702-826-0956
Mailing Address - Fax:
Practice Address - Street 1:4580 S EASTERN AVE STE 29
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6100
Practice Address - Country:US
Practice Address - Phone:702-826-0956
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty