Provider Demographics
NPI:1205663606
Name:TEMPLAR HEALTHCARE
Entity type:Organization
Organization Name:TEMPLAR HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:TEMPLAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-222-0566
Mailing Address - Street 1:PO BOX 230610
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89105-0610
Mailing Address - Country:US
Mailing Address - Phone:914-222-0566
Mailing Address - Fax:775-855-5853
Practice Address - Street 1:4300 W TROPICANA AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-5414
Practice Address - Country:US
Practice Address - Phone:914-222-0566
Practice Address - Fax:775-855-5853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-18
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental MedicineGroup - Multi-Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Multi-Specialty