Provider Demographics
NPI:1740446558
Name:VAHEY & GLUCK HAND SURGERY, LTD
Entity type:Organization
Organization Name:VAHEY & GLUCK HAND SURGERY, LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BO
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUTISTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-798-8585
Mailing Address - Street 1:8585 S EASTERN AVE
Mailing Address - Street 2:#100
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-2817
Mailing Address - Country:US
Mailing Address - Phone:702-798-8585
Mailing Address - Fax:702-341-0109
Practice Address - Street 1:8585 S EASTERN AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-2817
Practice Address - Country:US
Practice Address - Phone:702-798-8585
Practice Address - Fax:702-341-0109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-31
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV33935OtherMEDICARE ID
NV4323860001Medicare NSC
NVV33935OtherMEDICARE ID