Provider Demographics
NPI:1134560196
Name:BABERO, ALEJANDRO ZACARIAS
Entity type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:ZACARIAS
Last Name:BABERO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3104 SKIPWORTH DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89107-3242
Mailing Address - Country:US
Mailing Address - Phone:702-812-2989
Mailing Address - Fax:
Practice Address - Street 1:3104 SKIPWORTH DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89107-3242
Practice Address - Country:US
Practice Address - Phone:702-812-2989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-07
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program