Provider Demographics
NPI:1770268781
Name:CAZARES, FELIPE (DPT)
Entity type:Individual
Prefix:
First Name:FELIPE
Middle Name:
Last Name:CAZARES
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2225 CIVIC CENTER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89030-6328
Mailing Address - Country:US
Mailing Address - Phone:702-586-5778
Mailing Address - Fax:702-586-5758
Practice Address - Street 1:2225 CIVIC CENTER DR STE 100
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-6328
Practice Address - Country:US
Practice Address - Phone:702-586-5778
Practice Address - Fax:702-586-5758
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-19
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4917225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist