Provider Demographics
NPI:1770945768
Name:LOUIS, ALVANCIN (MD)
Entity type:Individual
Prefix:
First Name:ALVANCIN
Middle Name:
Last Name:LOUIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:801 S RANCHO DR STE E6
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-3812
Mailing Address - Country:US
Mailing Address - Phone:702-240-6482
Mailing Address - Fax:
Practice Address - Street 1:5225 S DURANGO DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-0137
Practice Address - Country:US
Practice Address - Phone:702-240-6482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-28
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361714722086S0129X
FLMW1366472086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery