Thais Little White Mountains P C | |
801 E Williams Ave Fallon NV 89406-3052 | |
(702) 453-3799 | |
(702) 453-5741 |
Full Name | Thais Little White Mountains P C |
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Speciality | Internal Medicine |
Location | 801 E Williams Ave, Fallon, Nevada |
Authorized Official Name and Position | Warren Phuc Thai (OWNER) |
Authorized Official Contact | 7753138926 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Thais Little White Mountains P C Po Box 18228 Reno NV 89511-0228 Ph: (702) 453-3799 | Thais Little White Mountains P C 801 E Williams Ave Fallon NV 89406-3052 Ph: (702) 453-3799 |
NPI Number | 1770980690 |
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Provider Enumeration Date | 11/20/2014 |
Last Update Date | 11/20/2014 |
Medicare PECOS PAC ID | 4284956061 |
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Medicare Enrollment ID | O20141205000469 |
Identifier | Type | State | Issuer |
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1770980690 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 13174 (Nevada) | Primary |
Provider Name | Warren P Thai |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1902923451 PECOS PAC ID: 5991850604 Enrollment ID: I20110207000600 |
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