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Organization
REUBEN I THAKER MD PLLC
Active
Organization
REUBEN I THAKER MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REUBEN THAKER MD (OWNER)
(702) 545-0660
Entity
Organization
Contact information
Practice address
9420 W SAHARA AVE STE 105, LAS VEGAS, NV 89117-8800
(702) 545-0660
(253) 461-7851
Mailing address
9420 W SAHARA AVE STE 105, LAS VEGAS, NV 89117-8800
(702) 545-0660
(253) 461-7851
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
208VP0000X
Pain Medicine Physician
—
NULL
208VP0000X
Pain Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1881890432
—
NV
Enumeration date
11/08/2018
Last updated
11/08/2018
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