Provider Demographics
NPI:1144558552
Name:ROGER W. HSIUNG MD PLLC
Entity type:Organization
Organization Name:ROGER W. HSIUNG MD PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:
Authorized Official - Last Name:HSIUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-586-6688
Mailing Address - Street 1:6080 S DURANGO DR STE 105
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-1778
Mailing Address - Country:US
Mailing Address - Phone:702-586-6688
Mailing Address - Fax:702-586-9988
Practice Address - Street 1:6080 S DURANGO DR STE 105
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-1778
Practice Address - Country:US
Practice Address - Phone:702-586-6688
Practice Address - Fax:702-586-9988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-23
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV12877208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1578687661OtherINDIVIDUAL NPI NUMBER
12003638OtherCAQH