Provider Demographics
NPI:1174716708
Name:HENDERSON SURGERY CENTER
Entity type:Organization
Organization Name:HENDERSON SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RAJAT
Authorized Official - Middle Name:
Authorized Official - Last Name:SOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-921-6829
Mailing Address - Street 1:1110 WIGWAM PKWY
Mailing Address - Street 2:SUITE 105
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-8185
Mailing Address - Country:US
Mailing Address - Phone:702-921-6829
Mailing Address - Fax:702-921-6828
Practice Address - Street 1:1110 WIGWAM PKWY
Practice Address - Street 2:SUITE 105
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-8185
Practice Address - Country:US
Practice Address - Phone:702-921-6829
Practice Address - Fax:702-921-6828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-27
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV743038261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical