Individual
RESTY T TIBAYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2460 W HORIZON RIDGE PKWY, HENDERSON, NV 89052-2648
(702) 822-2000
(702) 938-2232
Mailing address
400 N STEPHANIE ST STE 300, HENDERSON, NV 89014-6692
(702) 952-3350
(702) 952-3365
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
04-35742
KS
207RH0003X
Hematology & Oncology Physician
Primary
17659
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200484440A
—
OK
05
—
200964510A
—
KS
05
—
200964510C
—
KS
Enumeration date
07/03/2008
Last updated
03/21/2024
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