Provider Demographics
NPI:1386000586
Name:FLAMINGO PAIN SPECIALISTS LAIRD, PLLC
Entity type:Organization
Organization Name:FLAMINGO PAIN SPECIALISTS LAIRD, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIAL
Authorized Official - Middle Name:
Authorized Official - Last Name:LAIRD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-202-3700
Mailing Address - Street 1:4175 S RILEY ST STE 102
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-8719
Mailing Address - Country:US
Mailing Address - Phone:702-202-3700
Mailing Address - Fax:
Practice Address - Street 1:4175 S RILEY ST STE 102
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-8719
Practice Address - Country:US
Practice Address - Phone:702-202-3700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-05
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7912207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty