Provider Demographics
NPI:1669565479
Name:GREEN VALLEY OB-GYN LLP
Entity type:Organization
Organization Name:GREEN VALLEY OB-GYN LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:GUY
Authorized Official - Middle Name:A
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-260-0600
Mailing Address - Street 1:100 N GREEN VALLEY PKWY #345
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074
Mailing Address - Country:US
Mailing Address - Phone:702-260-0600
Mailing Address - Fax:702-260-4444
Practice Address - Street 1:100 N GREEN VALLEY PKWY #345
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074
Practice Address - Country:US
Practice Address - Phone:702-260-0600
Practice Address - Fax:702-260-4444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100508062Medicaid