1437164217 NPI number — THOMAS P BROOKS MS RPT CHARTERED

Table of content: (NPI 1437164217)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437164217 NPI number — THOMAS P BROOKS MS RPT CHARTERED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THOMAS P BROOKS MS RPT CHARTERED
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:
1437164217
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/03/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3121 S MARYLAND PARKWAY
Provider Second Line Business Mailing Address:
SUITE 612
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89109
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-734-6114
Provider Business Mailing Address Fax Number:
702-734-8457

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8440 W LAKE MEAD BLVD
Provider Second Line Business Practice Location Address:
SUITE 111
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89128
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-363-9000
Provider Business Practice Location Address Fax Number:
702-363-1978
Provider Enumeration Date:
07/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BROOKS
Authorized Official First Name:
THOMAS
Authorized Official Middle Name:
P
Authorized Official Title or Position:
OWNER PRESIDENT
Authorized Official Telephone Number:
702-734-6114

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com