Individual
TRICIA AGUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 N GREEN VALLEY PKWY STE 239, HENDERSON, NV 89074-7704
(702) 844-4841
(702) 844-4844
Mailing address
2370 CORPORATE CIR STE 300, HENDERSON, NV 89074-7760
(702) 910-3950
(702) 778-2264
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13714
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063691673
—
NV
Enumeration date
10/31/2007
Last updated
10/26/2021
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