Provider Demographics
NPI:1912429093
Name:ROCK & ROWLES PEDIATRICS PC
Entity type:Organization
Organization Name:ROCK & ROWLES PEDIATRICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:ROWLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-413-7130
Mailing Address - Street 1:6920 S CIMARRON RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-2135
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2380 N BUFFALO DR STE 145
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-4807
Practice Address - Country:US
Practice Address - Phone:702-413-7130
Practice Address - Fax:702-413-7280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-11
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1912429093Medicaid
AZ404841Medicaid