| Ricardo Fontillas Md | |
|
1090 Wigwam Parkway #100 Henderson NV 89074 | |
| (702) 454-0201 | |
| (702) 454-1245 |
| Full Name | Ricardo Fontillas Md |
|---|---|
| Speciality | Psychiatry & Neurology - Child & Adolescent Psychiatry |
| Location | 1090 Wigwam Parkway, Henderson, Nevada |
| Authorized Official Name and Position | Rico Fontillas (OWNER) |
| Authorized Official Contact | 7024540201 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ricardo Fontillas Md 1090 Wigwam Parkway #100 Henderson NV 89074 Ph: (702) 454-0201 | Ricardo Fontillas Md 1090 Wigwam Parkway #100 Henderson NV 89074 Ph: (702) 454-0201 |
| NPI Number | 1043424443 |
|---|---|
| Provider Enumeration Date | 05/09/2007 |
| Last Update Date | 11/30/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043424443 | NPI | - | NPPES |
| 002019612 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | 6501 (Nevada) | Primary |
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