Provider Demographics
NPI:1720805211
Name:DAX WOLFORD MD PLLC
Entity type:Organization
Organization Name:DAX WOLFORD MD PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAX
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:WOLFORD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-550-2620
Mailing Address - Street 1:8905 W POST RD STE 110
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-2429
Mailing Address - Country:US
Mailing Address - Phone:702-490-9449
Mailing Address - Fax:
Practice Address - Street 1:8905 W POST RD STE 110
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-2429
Practice Address - Country:US
Practice Address - Phone:702-550-2620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-25
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty