Provider Demographics
NPI:1851787691
Name:RICHARDS COSMETIC SURGERY, INC
Entity Type:Organization
Organization Name:RICHARDS COSMETIC SURGERY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRYSON
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-870-7070
Mailing Address - Street 1:6020 S RAINBOW BLVD
Mailing Address - Street 2:BLDG C
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-2545
Mailing Address - Country:US
Mailing Address - Phone:702-870-7070
Mailing Address - Fax:702-870-0068
Practice Address - Street 1:6020 S RAINBOW BLVD
Practice Address - Street 2:BLDG C
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-2545
Practice Address - Country:US
Practice Address - Phone:702-870-7070
Practice Address - Fax:702-870-0068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-08
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV15319208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty