Irene M. Bourgault Do Pc

NPI 1255511739 - Family Medicine - 207Q00000X

NPI Details
NPI 1255511739
Enumeration Date 11/13/2007
Last Updated 12/18/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name IRENE MARY IRENE
Position OWNER
Phone (702) 648-6228
Fax (702) 648-9868
Practice Location
3150 N TENAYA WAY STE 660
LAS VEGAS NV, 89128-0460, US
Phone (702) 648-6228
Fax (702) 648-9868
Business Location
3150 N TENAYA WAY STE 660
LAS VEGAS NV, 89128-0460, US
Phone (702) 648-6228
Fax (702) 648-9868
Toxanomy
Taxonomy Code 207Q00000X
License State Nevada
License Number 350
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According to our database, Irene M. Bourgault Do Pc NPI is 1255511739, taxonomy code is 207Q00000X and license number is 350, license state is located at Nevada. Irene M. Bourgault Do Pc physically located at 3150 N Tenaya Way Ste 660, Las Vegas NV, 89128-0460. NPI Number 1033115704 has the healthcare provider type.

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1255511739 NPI number is provided on an as is basis without warranty of any kind. 1255511739 is maintained by the National Plan & Provider Enumeration System. The contents of Irene M. Bourgault Do Pc are for informational purposes only.