| J. Tyler Gubler, D.o., Pllc | |
|
2250 E Flamingo Rd Las Vegas NV 89119-5170 | |
| (702) 784-4300 | |
| Not Available |
| Full Name | J. Tyler Gubler, D.o., Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 2250 E Flamingo Rd, Las Vegas, Nevada |
| Authorized Official Name and Position | Jason Tyler Gubler (MANAGING MEMBER) |
| Authorized Official Contact | 7022563637 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| J. Tyler Gubler, D.o., Pllc 213 N Stephanie St Ste G, Box 191 Henderson NV 89074 Ph: () - | J. Tyler Gubler, D.o., Pllc 2250 E Flamingo Rd Las Vegas NV 89119-5170 Ph: (702) 784-4300 |
| NPI Number | 1184257297 |
|---|---|
| Provider Enumeration Date | 02/17/2020 |
| Last Update Date | 02/21/2020 |
| Medicare PECOS PAC ID | 0648609438 |
|---|---|
| Medicare Enrollment ID | O20200330002321 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184257297 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jason T Gubler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063827715 PECOS PAC ID: 8426371097 Enrollment ID: I20150803001718 |
| Provider Name | Gloria Santiaguel Mandel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528566460 PECOS PAC ID: 0143582965 Enrollment ID: I20180314002391 |
| Provider Name | Valerie Charlotte Hart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265007033 PECOS PAC ID: 4284033838 Enrollment ID: I20210601002643 |
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