Provider Demographics
NPI:1487481537
Name:HEALTHY ORGAN ADVANCED PRACTICE PLLC
Entity type:Organization
Organization Name:HEALTHY ORGAN ADVANCED PRACTICE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:MACARAIG-ORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:702-602-2610
Mailing Address - Street 1:2801 S VALLEY VIEW BLVD STE 4
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-0116
Mailing Address - Country:US
Mailing Address - Phone:702-602-2610
Mailing Address - Fax:
Practice Address - Street 1:2801 S VALLEY VIEW BLVD STE 4
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-0116
Practice Address - Country:US
Practice Address - Phone:702-602-2610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-13
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty