Basic Information
| Provider Information | |||||||||
| NPI: | 1104179175 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SUNBELT OASIS EMERGENCY PHYSICIANS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 98729 | ||||||||
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| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891938729 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8004447009 | ||||||||
| FaxNumber: | 8003053233 | ||||||||
| Practice Location | |||||||||
| Address1: | 42121 US HWY 70 | ||||||||
| Address2: | |||||||||
| City: | PORTALES | ||||||||
| State: | NM | ||||||||
| PostalCode: | 88130 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5753591800 | ||||||||
| FaxNumber: | 5753569210 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/16/2012 | ||||||||
| LastUpdateDate: | 08/12/2019 | ||||||||
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| AuthorizedOfficialLastName: | KONDAS | ||||||||
| AuthorizedOfficialFirstName: | KATHY | ||||||||
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| AuthorizedOfficialTitleorPosition: | OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 9548382371 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.