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Contact Information

BACCHUS PC
880 SEVEN HILLS DR STE 140
HENDERSON, NV89052-4372
 Phone: 702-844-4840
 Fax: 702-844-4843
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
 

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Physician Assistant

363A00000X 97 Physician Assistant
 

Urgent Care

261QU0200X
Indicates primary specialty

NPI Profile & details for BACCHUS PC · (Female)

NPI # 1134628480
Status Active
Credentials
Entity Individual
Enumeration date 02/01/2018
Last updated 04/01/2026 - About 2 months ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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