Provider Demographics
NPI:1295423507
Name:JOEL RAINWATER MD NV, PLLC
Entity type:Organization
Organization Name:JOEL RAINWATER MD NV, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RAINWATER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-219-0123
Mailing Address - Street 1:PO BOX 208313
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75320-8313
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5443 KIETZKE LN # 100
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-1088
Practice Address - Country:US
Practice Address - Phone:775-502-1660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMPREHENSIVE INTERVENTIONAL CARE CENTERS, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty