# MACK VEIN SPECIALISTS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Great Basin Vein Specialists
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114700770
- **Authorized official:** ANWAR SELASSIE MACK MD (PRESIDENT)
- **Authorized official phone:** (832) 744-0949

## Contact information

- **Practice address:** 605 SIERRA ROSE DR STE 4, RENO, NV 89511-2093
- **Practice address phone:** (775) 451-1730
- **Practice address fax:** (775) 451-1713
- **Mailing address:** 605 SIERRA ROSE DR STE 4, RENO, NV 89511-2093
- **Mailing address phone:** (775) 451-1730
- **Mailing address fax:** (775) 451-1713

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/17/2023
- **Last updated:** 10/12/2023