Provider Demographics
NPI:1942718101
Name:KEVIN P. DEBIPARSHAD PLLC
Entity Type:Organization
Organization Name:KEVIN P. DEBIPARSHAD PLLC
Other - Org Name:SYNERGY SPINE ORTHOPEDICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DEBIPARSHAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-678-4658
Mailing Address - Street 1:8180 RAFAEL RIVERA WAY STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-5429
Mailing Address - Country:US
Mailing Address - Phone:702-678-4658
Mailing Address - Fax:844-254-1850
Practice Address - Street 1:8180 RAFAEL RIVERA WAY STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-5429
Practice Address - Country:US
Practice Address - Phone:702-678-4658
Practice Address - Fax:844-254-1850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-22
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty