Individual
BRENT DEVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
650 N NELLIS BLVD, LAS VEGAS, NV 89110
(702) 790-8000
Mailing address
650 N NELLIS BLVD, LAS VEGAS, NV 89110-5382
(702) 790-8000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO1958
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1609134048
—
NY
Enumeration date
04/23/2012
Last updated
08/21/2020
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