# REUBEN I THAKER MD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629546585
- **Authorized official:** REUBEN THAKER MD (OWNER)
- **Authorized official phone:** (702) 545-0660

## Contact information

- **Practice address:** 9420 W SAHARA AVE STE 105, LAS VEGAS, NV 89117-8800
- **Practice address phone:** (702) 545-0660
- **Practice address fax:** (253) 461-7851
- **Mailing address:** 9420 W SAHARA AVE STE 105, LAS VEGAS, NV 89117-8800
- **Mailing address phone:** (702) 545-0660
- **Mailing address fax:** (253) 461-7851

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 208VP0000X | Pain Medicine Physician | — | NULL | — |
| 208VP0000X | Pain Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 11/08/2018
- **Last updated:** 11/08/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1881890432 | — | NV |