| Sundance Medical Center Llp | |
|
500 E Windmill Ln Ste 125 Las Vegas NV 89123-1845 | |
| (702) 263-4795 | |
| (702) 263-4804 |
| Full Name | Sundance Medical Center Llp |
|---|---|
| Speciality | Internal Medicine |
| Location | 500 E Windmill Ln Ste 125, Las Vegas, Nevada |
| Authorized Official Name and Position | Patricia Peckham (BILLING MANAGER) |
| Authorized Official Contact | 7022634795 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sundance Medical Center Llp 105 N Pecos Rd Ste 113 Henderson NV 89074-1995 Ph: (702) 263-4795 | Sundance Medical Center Llp 500 E Windmill Ln Ste 125 Las Vegas NV 89123-1845 Ph: (702) 263-4795 |
| NPI Number | 1447301973 |
|---|---|
| Provider Enumeration Date | 01/12/2007 |
| Last Update Date | 12/06/2017 |
| Medicare PECOS PAC ID | 6507844503 |
|---|---|
| Medicare Enrollment ID | O20040707001259 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447301973 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Jessica Summer Lucero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487726519 PECOS PAC ID: 3173558772 Enrollment ID: I20051003000556 |
| Provider Name | Heather Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528223906 PECOS PAC ID: 4789742529 Enrollment ID: I20081022000474 |
| Provider Name | Justin Matthew Striblen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962563569 PECOS PAC ID: 8921030461 Enrollment ID: I20120215000966 |
| Provider Name | Thomas Andrew Peters |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659432250 PECOS PAC ID: 9830121375 Enrollment ID: I20120404000798 |
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