Provider Demographics
NPI:1508812306
Name:GASPAR, ARNEL V (MPT)
Entity Type:Individual
Prefix:
First Name:ARNEL
Middle Name:V
Last Name:GASPAR
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9421 HIDDEN CAVE CT.
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149
Mailing Address - Country:US
Mailing Address - Phone:702-882-9727
Mailing Address - Fax:
Practice Address - Street 1:2851 N TENAYA WAY
Practice Address - Street 2:STE 205
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0453
Practice Address - Country:US
Practice Address - Phone:702-655-9456
Practice Address - Fax:702-655-9594
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1978225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100509966Medicaid
NVV102591Medicare PIN