| Guillermo Fraga, M.d. A Professional Corporation | |
|
2649 Wigwam Pkwy Suite 100 Henderson NV 89074-7310 | |
| (702) 452-3002 | |
| Not Available |
| Full Name | Guillermo Fraga, M.d. A Professional Corporation |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 2649 Wigwam Pkwy, Henderson, Nevada |
| Authorized Official Name and Position | Guillermo Hugo Fraga (PHYSICIAN) |
| Authorized Official Contact | 7024523002 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Guillermo Fraga, M.d. A Professional Corporation 2649 Wigwam Pkwy Suite 100 Henderson NV 89074-7310 Ph: (702) 452-3002 | Guillermo Fraga, M.d. A Professional Corporation 2649 Wigwam Pkwy Suite 100 Henderson NV 89074-7310 Ph: (702) 452-3002 |
| NPI Number | 1992992978 |
|---|---|
| Provider Enumeration Date | 10/03/2007 |
| Last Update Date | 10/03/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992992978 | NPI | - | NPPES |
| NV02663 | Other | NV | MEDICARE EDI |
| 002019808 | Medicaid | NV | |
| 101047 | Other | NV | GROUP PIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 7867 (Nevada) | Primary |
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