Provider Demographics
NPI:1487942496
Name:ENDER ANESTHESIOLOGY, P.C.
Entity type:Organization
Organization Name:ENDER ANESTHESIOLOGY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:IIRWIN
Authorized Official - Last Name:ENDER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:702-247-1221
Mailing Address - Street 1:1930 VILLAGE CENTER CIR
Mailing Address - Street 2:BOX 3-395
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89134-6299
Mailing Address - Country:US
Mailing Address - Phone:702-449-4284
Mailing Address - Fax:702-247-1225
Practice Address - Street 1:1930 VILLAGE CENTER CIR
Practice Address - Street 2:BOX 3-395
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89134-6299
Practice Address - Country:US
Practice Address - Phone:702-449-4284
Practice Address - Fax:702-247-1225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-12
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1205207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVDR458ZMedicare PIN