GUILLERMO FRAGA, M.D. A PROFESSIONAL CORPORATION (NPI# 1992992978) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992992978 |
| Entity Type | Organization |
| Organization Name | GUILLERMO FRAGA, M.D. A PROFESSIONAL CORPORATION |
| Practice Address |
2649 Wigwam Pkwy Suite 100 Henderson NV 89074-7310 |
| Practice Telephone | 7024523002 |
| Mailing Telephone | 7024523002 |
| Enumeration Date | 2007-10-03 |
| Last Update Date | 2007-10-03 |
| Authorized Official Name | DR. GUILLERMO HUGO FRAGA (PHYSICIAN) |
| Authorized Official Telephone | 7024523002 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
7867 | NV | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NV | GROUP PIN | 101047 | 01 |
| NV | MEDICARE EDI | NV02663 | 01 |
| NV | 002019808 | 05 |
| Street Address |
2649 WIGWAM PKWY SUITE 100 |
| City | HENDERSON |
| State | NV |
| Zip Code | 89074-7310 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174570816 | Katherine A Keeley | Oral & Maxillofacial Surgery | 2649 Wigwam Pkwy, Suite 102, Henderson, NV 89074-7310 | 2006-05-28 |
| 1578024642 | Ileana Alexandra Miron Yee | Nurse Practitioner | 2649 Wigwam Pkwy, Henderson, NV 89074-7367 | 2019-03-29 |
| 1083183735 | Nadine Haddad | Nurse Practitioner | 2649 Wigwam Pkwy, Henderson, NV 89074-7367 | 2018-11-23 |
| 1710110838 | Sameera Sbaih Md Prof Corp | Family Medicine | 2649 Wigwam Pkwy, Suite #100, Henderson, NV 89074-7310 | 2009-08-24 |
| 1659594067 | Yelena Piyevsky Dds Inc, A Professional Dental Corporation | Dentist | 2649 Wigwam Pkwy, Ste. 106, Henderson, NV 89074-7310 | 2007-04-11 |
| 1639243538 | Sameera Sbaih | Family Medicine | 2649 Wigwam Pkwy, Suite 100, Henderson, NV 89074-7367 | 2006-11-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194349381 | Samuel Taylor Mulford | Physical Therapist | 9070 W.cheyenne Ave, Suite 100, Henderson, NV 89074 | 2020-06-03 |
| 1407369127 | Brenda Thomas | Dental Hygienist | 234 Polar Morning Place, Henderson, NV 89074 | 2017-11-16 |
| 1174036479 | Gail E Evans Wade | Behavioral Analyst | 1445 Stone Lake Cove, Henderson, NV 89074 | 2017-11-08 |
| 1710400957 | Kimberley Houk | Behavioral Analyst | 20 Avenida Picasso, Henderson, NV 89074 | 2017-07-19 |
| 1760911846 | Colin Ono-moore | Physical Therapist | 3 Rising Sun Ct, Henderson, NV 89074 | 2017-06-12 |
| 1851825764 | Ralph Wieder | Dietitian, Registered | 1005 Wigwam Pkwy, 23206, Henderson, NV 89074 | 2017-04-18 |
| 1811421712 | Henderson Long Term Care LLC | Skilled Nursing Facility | 2965 Wigwam Parkway, Henderson, NV 89074 | 2017-04-18 |
| 1275994642 | Malyna Lavarias | Behavioral Analyst | 74 N Pecos Rd., Suite C, Henderson, NV 89074 | 2016-03-14 |
| 1144608290 | Matthew Roderick | Acupuncturist | 2675 Windmill Pkwy Apt 421, Henderson, NV 89074 | 2015-05-08 |
| 1922494764 | Jennifer Romo Santistevan | Pediatrics | 1505 Wigwam Pkwy Ste 230, Henderson, NV 89074 | 2015-04-08 |
| Find all providers in zip 89074 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194369793 | Western Mountain Medical Center, PC | Clinic/Center | 2482 W Horizon Ridge Pkwy Ste 100, Henderson, NV 89052-2726 | 2019-11-06 |
| 1992269336 | Activate Healthcare - Local 14 Henderson App | Clinic/Center | 1505 Wigwam Pkwy # 241, Henderson, NV 89074-8194 | 2019-01-30 |
| 1730573908 | Wellness and Education Centers of Nevada, Inc | Clinic/Center | 601 Whitney Ranch Dr Ste C12, Henderson, NV 89014-2643 | 2015-03-25 |
| 1669817334 | Complete Medical Consultants, LLC | Clinic/Center | 2920 N Green Valley Pkwy Ste 821, Henderson, NV 89014-0409 | 2013-05-07 |
| 1104013739 | Marisa C Medina Md PC | Clinic/Center | 11201 S Eastern #120, Henderson, NV 89052-6200 | 2007-09-27 |
| 1770770307 | Hipp Medical Services Inc PC | Clinic/Center | 11201 S Eastern Ave Ste 120, Henderson, NV 89052-6200 | 2007-09-27 |
| 1407043201 | Badar Anwar Md PC | Clinic/Center | 660 S Green Valley Pkwy Ste 100, Henderson, NV 89052-0431 | 2007-09-26 |
| 1760005995 | Dr. Nikki, Np LLC | Clinic/Center | 1070 W Horizon Ridge Pkwy Ste 111, Henderson, NV 89012-6019 | 2020-05-21 |
| 1922565746 | Activate Healthcare - Local 14 Henderson Md | Clinic/Center | 1505 Wigwam Pkwy # 241, Henderson, NV 89074-8194 | 2019-02-28 |
| 1649741935 | Activate Healthcare - Local 14 Henderson Clinic | Clinic/Center | 1505 Wigwam Pkwy Ste 241, Henderson, NV 89074-8194 | 2018-12-11 |
| Find all providers in HENDERSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.