Organization
BEDUYA-PRINCER, LLC
Active
Other names
Envigor Medical and Behavioral Center
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA TESSIE BEDUYA-PRINCER (CEO)
(702) 902-0225
Entity
Organization
Contact information
Practice address
8565 S EASTERN AVE STE 150, LAS VEGAS, NV 89123-2906
(702) 902-0225
Mailing address
8565 S EASTERN AVE STE 150, LAS VEGAS, NV 89123-2906
(702) 902-0225
Taxonomy
Speciality
Code
Description
License number
State
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
12/09/2021
Last updated
12/09/2021
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