Provider Demographics
NPI:1891126157
Name:CLINICA MEDICA VARGAS & ALMONTE
Entity Type:Organization
Organization Name:CLINICA MEDICA VARGAS & ALMONTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:VARGAS LAGUNAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-476-9600
Mailing Address - Street 1:2832 E LAKE MEAD BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89030-6550
Mailing Address - Country:US
Mailing Address - Phone:702-476-9600
Mailing Address - Fax:
Practice Address - Street 1:2832 E LAKE MEAD BLVD STE E
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-6550
Practice Address - Country:US
Practice Address - Phone:702-476-9600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIGUEL A VARGAS LAGUNAS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-12-11
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV12464261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center