Provider Demographics
NPI:1013980580
Name:YEE, THOMAS C (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:C
Last Name:YEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1921 REALEZA COURT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-6017
Mailing Address - Country:US
Mailing Address - Phone:702-813-3888
Mailing Address - Fax:702-252-8826
Practice Address - Street 1:1921 REALEZA CT
Practice Address - Street 2:STE. 200
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-2062
Practice Address - Country:US
Practice Address - Phone:702-562-3590
Practice Address - Fax:702-252-8826
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-07
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6769207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002019428Medicaid
NVMD6769Medicare ID - Type Unspecified
NV002019428Medicaid