1093730905 NPI number — BUD A. WEST, M. D., LTD.

Table of content: (NPI 1093730905)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093730905 NPI number — BUD A. WEST, M. D., LTD.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BUD A. WEST, M. D., LTD.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093730905
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
343 ELM ST
Provider Second Line Business Mailing Address:
STE 204
Provider Business Mailing Address City Name:
RENO
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89503
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
775-323-2157
Provider Business Mailing Address Fax Number:
775-323-0749

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
343 ELM ST
Provider Second Line Business Practice Location Address:
STE 204
Provider Business Practice Location Address City Name:
RENO
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-323-2157
Provider Business Practice Location Address Fax Number:
775-323-0749
Provider Enumeration Date:
07/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WEST
Authorized Official First Name:
BUD
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
775-323-2157

Provider Taxonomy Codes

  • Taxonomy code: 207Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: DD5634 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com