Organization
PRIME CARDIOLOGY GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELONIE SINCLAIR (SR. CREDENTIALING SPECIALIST)
(281) 673-7752
Entity
Organization
Contact information
Practice address
9950 W CHEYENNE AVE, LAS VEGAS, NV 89129-7700
(702) 805-5678
(725) 204-0423
Mailing address
2855 SAINT ROSE PKWY STE 110, HENDERSON, NV 89052-4812
(702) 805-5678
(725) 204-0423
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
—
—
207RI0011X
Interventional Cardiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11289
NEVADA MEDICAL LICENSE
NV
01
—
NV20201689839
NEVADA STATE BUSINESS LICENSE
NV
Enumeration date
01/28/2020
Last updated
03/10/2026
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