Provider Demographics
NPI:1861511271
Name:LAS VEGAS PAIUTE TRIBE HEALTH & HUMAN SERVICES
Entity Type:Organization
Organization Name:LAS VEGAS PAIUTE TRIBE HEALTH & HUMAN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-382-0784
Mailing Address - Street 1:1257 PAIUTE CIR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-3202
Mailing Address - Country:US
Mailing Address - Phone:702-382-0784
Mailing Address - Fax:702-384-5272
Practice Address - Street 1:1257 PAIUTE CIR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-3202
Practice Address - Country:US
Practice Address - Phone:702-382-0784
Practice Address - Fax:702-384-5272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty