MEDICARE: HYDER THERAPEUTIC ALLIANCE PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1174998173
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HYDER THERAPEUTIC ALLIANCE PLLC

Provider Business Mailing Address
First Line	:	2248 VIA CADOMA
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-7817
Country	:	US
Telephone Number	:	702-444-4690
Fax Number	:	702-684-4470

Provider Business Practice Location Address
First Line	:	2248 VIA CADOMA
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-7817
Country	:	US
Telephone Number	:	702-444-4690
Fax Number	:	702-684-4470

Authorized Official
Title or Position	:	OWNER / M.D.
Name	:	MUHAMMAD ALI HYDER
Credential	:	M.D.
Telephone Number	:	702-444-4690

Provider Enumeration Date	:	12/02/2015
Last Update Date	:	12/02/2015

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