Provider Demographics
NPI:1801507462
Name:FRANCISCO G. MACHUCA M.D. LLC
Entity type:Organization
Organization Name:FRANCISCO G. MACHUCA M.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:G
Authorized Official - Last Name:MACHUCA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-533-3465
Mailing Address - Street 1:15969 ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68135-6325
Mailing Address - Country:US
Mailing Address - Phone:530-990-6519
Mailing Address - Fax:702-850-9105
Practice Address - Street 1:1513 S EASTERN AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-3916
Practice Address - Country:US
Practice Address - Phone:702-340-9746
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-05
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty