Provider Demographics
NPI:1528184637
Name:NEVADA RADIATION ONCOLOGY WEST LLC
Entity Type:Organization
Organization Name:NEVADA RADIATION ONCOLOGY WEST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:T
Authorized Official - Last Name:MEOZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-233-2200
Mailing Address - Street 1:400 N STEPHANIE ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014
Mailing Address - Country:US
Mailing Address - Phone:702-952-3350
Mailing Address - Fax:702-952-3365
Practice Address - Street 1:655 N TOWN CENTER DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89144-6367
Practice Address - Country:US
Practice Address - Phone:702-233-2200
Practice Address - Fax:702-233-2210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVVWDBYGMedicare PIN