Individual
DR. EUGENE G PORRECA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7106 SMOKE RANCH RD, SUITE 120, LAS VEGAS, NV 89128
(702) 869-4554
(702) 796-9225
Mailing address
9030 W SAHARA AVE, #550, LAS VEGAS, NV 89117-5744
(702) 869-4554
(702) 228-5653
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
5987
NV
2086S0129X
Vascular Surgery Physician
5987
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002019002
—
NV
01
—
770003058
RR
NV
01
—
770589284
TAX ID
NV
Enumeration date
03/15/2006
Last updated
06/26/2012
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