Provider Demographics
NPI:1851551675
Name:COMPREHENSIVE ORTHOPEDICS LLC
Entity type:Organization
Organization Name:COMPREHENSIVE ORTHOPEDICS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SURGEON
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:CARLOS
Authorized Official - Last Name:BACOT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:340-779-2663
Mailing Address - Street 1:1887 WHITNEY MESA DR # 9001ZN
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-2069
Mailing Address - Country:US
Mailing Address - Phone:855-777-4853
Mailing Address - Fax:340-779-2443
Practice Address - Street 1:9151 ESTATE THOMAS
Practice Address - Street 2:SUITE 206 FOOTHILL PROFESSIONAL BLDG.
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-2617
Practice Address - Country:US
Practice Address - Phone:340-779-2663
Practice Address - Fax:340-779-2443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-16
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI1-6918-1L261QA1903X
VI174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory SurgicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VI0085477Medicare PIN