Provider Demographics
NPI:1831434851
Name:TASKER, ROBERT CASEY
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:CASEY
Last Name:TASKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 W HORIZON RIDGE PKWY
Mailing Address - Street 2:#120-130
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-5324
Mailing Address - Country:US
Mailing Address - Phone:702-825-1818
Mailing Address - Fax:
Practice Address - Street 1:687 MARINA DR
Practice Address - Street 2:UNIT 40
Practice Address - City:BOULDER CITY
Practice Address - State:NV
Practice Address - Zip Code:89005-1027
Practice Address - Country:US
Practice Address - Phone:702-825-1818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-03
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor