Provider Demographics
NPI:1942926126
Name:NEVADA ANESTHESIA CONSORTIUM PLLC
Entity Type:Organization
Organization Name:NEVADA ANESTHESIA CONSORTIUM PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:FABITO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-556-6943
Mailing Address - Street 1:1000 N GREEN VALLEY PKWY # 440-532
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-6170
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1748 W HORIZON RIDGE PKWY
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89012-4833
Practice Address - Country:US
Practice Address - Phone:702-982-1300
Practice Address - Fax:702-728-5661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty