Woundtech Of Nevada | |
6240 N Durango Dr Ste 120 Las Vegas NV 89149-3941 | |
(954) 923-7440 | |
(954) 923-1299 |
Full Name | Woundtech Of Nevada |
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Speciality | Internal Medicine |
Location | 6240 N Durango Dr Ste 120, Las Vegas, Nevada |
Authorized Official Name and Position | Minghsun Liu (CEO) |
Authorized Official Contact | 9549237440 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Woundtech Of Nevada 200 S Park Rd Ste 200 Hollywood FL 33021-8541 Ph: (954) 923-7440 | Woundtech Of Nevada 6240 N Durango Dr Ste 120 Las Vegas NV 89149-3941 Ph: (954) 923-7440 |
NPI Number | 1982002283 |
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Provider Enumeration Date | 12/18/2014 |
Last Update Date | 05/05/2023 |
Medicare PECOS PAC ID | 8820315047 |
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Medicare Enrollment ID | O20150327002039 |
Identifier | Type | State | Issuer |
---|---|---|---|
1982002283 | NPI | - | NPPES |
250001070 | Medicaid | NV |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
208600000X | Surgery | 12469 (Nevada) | Secondary |
Provider Name | Pankaj K Bhatnagar |
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Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1417929175 PECOS PAC ID: 4385724939 Enrollment ID: I20080424000578 |
Provider Name | Jimmy Cruza |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1063079234 PECOS PAC ID: 9830527019 Enrollment ID: I20200323000562 |
Provider Name | Jon Williams |
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Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1316385529 PECOS PAC ID: 9032444740 Enrollment ID: I20200821000380 |
Provider Name | Jackline H Duana |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1245752542 PECOS PAC ID: 2466726971 Enrollment ID: I20201130001804 |
Provider Name | Minghsun Liu |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1518096270 PECOS PAC ID: 3577626803 Enrollment ID: I20230413001793 |
Provider Name | Irena Krass |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1871287748 PECOS PAC ID: 6002267820 Enrollment ID: I20240105002365 |
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