Provider Demographics
NPI:1487007423
Name:VEINISHING LLC
Entity type:Organization
Organization Name:VEINISHING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED
Authorized Official - Prefix:
Authorized Official - First Name:CLOSED
Authorized Official - Middle Name:
Authorized Official - Last Name:CL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-000-0000
Mailing Address - Street 1:8174 LAS VEGAS BLVD S
Mailing Address - Street 2:STE 109-443
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-1029
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8174 LAS VEGAS BLVD S
Practice Address - Street 2:STE 109-443
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-1029
Practice Address - Country:US
Practice Address - Phone:916-585-3625
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-14
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV159342085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty