Provider Demographics
NPI:1982876124
Name:MYINT CENTER FOR EYE AND FACIAL PLASTIC SURGERY PC
Entity Type:Organization
Organization Name:MYINT CENTER FOR EYE AND FACIAL PLASTIC SURGERY PC
Other - Org Name:EYE AND FACIAL PLASTIC SURGERY OF LAS VEGAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SHOIB
Authorized Official - Middle Name:
Authorized Official - Last Name:MYINT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:702-207-6468
Mailing Address - Street 1:8550 W DESERT INN RD
Mailing Address - Street 2:SUITE 102-212
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-4401
Mailing Address - Country:US
Mailing Address - Phone:702-207-6468
Mailing Address - Fax:702-207-4486
Practice Address - Street 1:7955 W SAHARA AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-7910
Practice Address - Country:US
Practice Address - Phone:702-207-6468
Practice Address - Fax:702-207-4486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV105634Medicare PIN