Provider Demographics
NPI:1679784144
Name:KORD T. STREBEL, MD LLC
Entity Type:Organization
Organization Name:KORD T. STREBEL, MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KORD
Authorized Official - Middle Name:
Authorized Official - Last Name:STREBEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-385-3000
Mailing Address - Street 1:840 S RANCHO DR
Mailing Address - Street 2:#4-606
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-3837
Mailing Address - Country:US
Mailing Address - Phone:702-385-3000
Mailing Address - Fax:702-385-0982
Practice Address - Street 1:1950 PINTO LN
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4017
Practice Address - Country:US
Practice Address - Phone:702-385-3000
Practice Address - Fax:702-385-0982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11468174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV105124Medicare PIN