Provider Demographics
NPI:1932160959
Name:REX GARN MABEY JR M.D. CHARTERED
Entity type:Organization
Organization Name:REX GARN MABEY JR M.D. CHARTERED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:REX
Authorized Official - Middle Name:GARN
Authorized Official - Last Name:MABEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:702-242-8800
Mailing Address - Street 1:2881 N TENAYA WAY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0452
Mailing Address - Country:US
Mailing Address - Phone:702-242-8800
Mailing Address - Fax:702-242-8949
Practice Address - Street 1:2881 N TENAYA WAY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0452
Practice Address - Country:US
Practice Address - Phone:702-242-8800
Practice Address - Fax:702-242-8949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-29
Last Update Date:2011-04-11
Deactivation Date:2008-08-05
Deactivation Code:
Reactivation Date:2011-04-11
Provider Licenses
StateLicense IDTaxonomies
NV5758207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2002342Medicaid
NV1720048549OtherINDIVIDUAL NPI
NV1720048549OtherINDIVIDUAL NPI
NV2002342Medicaid