Psychophylaxis Institute LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

17489 Issued in NV

Legal business name

PSYCHOPHYLAXIS INSTITUTE LLC

Practice address

2470 E Flamingo Rd Ste D
Las Vegas, NV 89121-5200

Phone

(702) 544-3849

NPI assigned

Nov 18, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mudalodu Vasudevan

Title

Ceo

Phone

(646) 688-3579

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1510963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510963200000",
    "number": "1972017549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 W INVITAR LN",
            "city": "MOUNTAIN HOUSE",
            "state": "CA",
            "postal_code": "953912036",
            "telephone_number": "646-688-3579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2470 E FLAMINGO RD STE D",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891215200",
            "telephone_number": "702-544-3849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOPHYLAXIS INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-18",
        "last_updated": "2017-11-18",
        "status": "A",
        "authorized_official_last_name": "VASUDEVAN",
        "authorized_official_first_name": "MUDALODU",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "646-688-3579"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "17489",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301102270",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Psychiatric Management, LLC
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• Psychiatry Services Professional Corporation Khurana Jeider
• Psychological Solutions for Nevada
• Psychology Specialists LTD
• Psychplus Medical Associates PLLC
• Psychplus Medical Associates PLLC
• Ptcii Inc
• Pthompson Advance Practice
• PTW Holdings LLC

• Family Medicine Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Family Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.