Provider Demographics
NPI:1679340269
Name:HOGANS, LARRY JAMES
Entity type:Individual
Prefix:
First Name:LARRY
Middle Name:JAMES
Last Name:HOGANS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2880 E FLAMINGO RD STE G1
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-5229
Mailing Address - Country:US
Mailing Address - Phone:725-251-2795
Mailing Address - Fax:
Practice Address - Street 1:2880 E FLAMINGO RD STE G1
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-5229
Practice Address - Country:US
Practice Address - Phone:725-251-2795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant