Provider Demographics
NPI:1881466639
Name:PECOS MEDICAL GROUP
Entity type:Organization
Organization Name:PECOS MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:S
Authorized Official - Last Name:RINKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-802-5215
Mailing Address - Street 1:2657 WINDMILL PKWY # 346
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-3384
Mailing Address - Country:US
Mailing Address - Phone:877-468-0468
Mailing Address - Fax:
Practice Address - Street 1:3235 E WARM SPRINGS RD STE 175
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3187
Practice Address - Country:US
Practice Address - Phone:702-463-3300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-25
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty