Provider Demographics
NPI:1871322305
Name:GARCIA MORALES, PEDRO
Entity type:Individual
Prefix:
First Name:PEDRO
Middle Name:
Last Name:GARCIA MORALES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5900 W. TROPICANA AVE
Mailing Address - Street 2:TRAILER 92
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103
Mailing Address - Country:US
Mailing Address - Phone:702-328-3191
Mailing Address - Fax:702-549-8568
Practice Address - Street 1:4580 S. EASTERN AVENUE
Practice Address - Street 2:SUITE 30
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119
Practice Address - Country:US
Practice Address - Phone:702-954-4087
Practice Address - Fax:702-549-8568
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-01
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care