Provider Demographics
NPI:1922262187
Name:THE SLEEP CENTER OF NEVADA
Entity Type:Organization
Organization Name:THE SLEEP CENTER OF NEVADA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RACHAKONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRABHU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-877-9514
Mailing Address - Street 1:5701 W CHARLESTON BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-1256
Mailing Address - Country:US
Mailing Address - Phone:702-877-9514
Mailing Address - Fax:702-818-2440
Practice Address - Street 1:5701 W CHARLESTON BLVD STE 105
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-1256
Practice Address - Country:US
Practice Address - Phone:702-877-9514
Practice Address - Fax:702-818-2440
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:R.D.PRABHU-LATA K SHETE, MDS, LTD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3775207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty