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
Fax: (702) 877-4536
Website:

Health care specialties

SpecialtyCodeLicense #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 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689656357 NPPES
Nevada MEDICAID 100508284

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