Botla, Venugopal
Botla, Venugopal is an individual health care provider with primary practice located at 1294 S Jones Blvd Suite 12, Las Vegas NV 89146. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Botla, Venugopal can be contacted via phone (702) 877-1887.Contact Information
Primary practice address
1294 S Jones Blvd Suite 12
Las Vegas NV 89146
Phone: (702) 877-1887
Fax: (702) 877-4536
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | 11677 | Nevada |
Profile Details
| NPI number | 1689656357 |
|---|---|
| LBN Legal business name | Botla, Venugopal |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 17th, 2005 |
| Last updated | Jan 26th, 2024 - about 10 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689656357 | NPPES |
| Nevada | MEDICAID | 100508284 |
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