Provider Demographics
NPI:1609035567
Name:MARIA PILAR A. FAYLONA, M.D. PC
Entity Type:Organization
Organization Name:MARIA PILAR A. FAYLONA, M.D. PC
Other - Org Name:MARIA PILAR A. FAYLONA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:AVERION
Authorized Official - Last Name:ROMERO-SALAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-272-1291
Mailing Address - Street 1:4212 W CHARLESTON BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-1625
Mailing Address - Country:US
Mailing Address - Phone:702-312-2233
Mailing Address - Fax:702-318-7801
Practice Address - Street 1:4212 W CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1625
Practice Address - Country:US
Practice Address - Phone:027-312-2233
Practice Address - Fax:702-318-7801
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARIA PILAR A. FAYLONA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-05
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2019944Medicaid
NV2019944Medicaid
NVV32797Medicare PIN