# RICO FONTILLAS INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** RICO FONTILLAS INC
- **Other names:** Ricardo Fontillas MD
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1043424443
- **Legal business name:** RICO FONTILLAS INC
- **Authorized official:** RICO FONTILLAS MD (OWNER)
- **Authorized official phone:** (702) 454-0201

## Contact information

- **Practice address:** 1090 WIGWAM PARKWAY, \#100, HENDERSON, NV 89074
- **Practice address phone:** (702) 454-0201
- **Practice address fax:** (702) 454-1245
- **Mailing address:** 1090 WIGWAM PARKWAY, \#100, HENDERSON, NV 89074
- **Mailing address phone:** (702) 454-0201
- **Mailing address fax:** (702) 454-1245

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0804X | Child & Adolescent Psychiatry Physician | 6501 | NV | Yes |

## Other

- **Enumeration date:** 05/09/2007
- **Last updated:** 11/30/2007