Individual
GUILLERMO FRAGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2610 W. HORIZON PKWY., SUITE 105, HENDERSON, NV 89052
(702) 724-8777
(702) 724-8749
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 724-8777
(702) 724-8749
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
7867
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002019808
—
NV
Enumeration date
11/21/2005
Last updated
03/25/2015
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