Provider Demographics
NPI:1497923270
Name:FAMILY DOCTORS OF BOULDER CITY
Entity Type:Organization
Organization Name:FAMILY DOCTORS OF BOULDER CITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:HERVE
Authorized Official - Middle Name:
Authorized Official - Last Name:BEZARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-293-0406
Mailing Address - Street 1:895 ADAMS BLVD
Mailing Address - Street 2:
Mailing Address - City:BOULDER CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89005
Mailing Address - Country:US
Mailing Address - Phone:702-293-0406
Mailing Address - Fax:702-293-0192
Practice Address - Street 1:895 ADAMS BLVD
Practice Address - Street 2:
Practice Address - City:BOULDER CITY
Practice Address - State:NV
Practice Address - Zip Code:89005
Practice Address - Country:US
Practice Address - Phone:702-293-0406
Practice Address - Fax:702-293-0192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-14
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care