Provider Demographics
NPI:1508055260
Name:NEVADA CHILDREN'S CLINIC
Entity Type:Organization
Organization Name:NEVADA CHILDREN'S CLINIC
Other - Org Name:BRIGHT FUTURES PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAVI
Authorized Official - Middle Name:
Authorized Official - Last Name:KRISHNAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-944-4028
Mailing Address - Street 1:8352 WARM SPRINGS ROAD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113
Mailing Address - Country:US
Mailing Address - Phone:702-944-4028
Mailing Address - Fax:702-944-4019
Practice Address - Street 1:8352 W WARM SPRINGS RD
Practice Address - Street 2:SUITE 210
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-3628
Practice Address - Country:US
Practice Address - Phone:702-944-4028
Practice Address - Fax:702-944-4019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty