Provider Demographics
NPI:1518971993
Name:JAVIER, SOLOMON NICOLAS (MD)
Entity Type:Individual
Prefix:DR
First Name:SOLOMON
Middle Name:NICOLAS
Last Name:JAVIER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 W. CHARLESTON BLVD. STE. 508
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102
Mailing Address - Country:US
Mailing Address - Phone:702-383-2688
Mailing Address - Fax:702-671-6595
Practice Address - Street 1:61 N. NELLIS BLVD.
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110
Practice Address - Country:US
Practice Address - Phone:702-383-6240
Practice Address - Fax:702-459-8586
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6507207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1518971993OtherMEDICAID SMA & SMACC
NV2002556Medicaid
NV2002556Medicaid
NVF28483Medicare UPIN
NV30421Medicare ID - Type Unspecified