Healthcare Provider Details

I. General information

NPI: 1174448617
Provider Name (Legal Business Name): STAMBULYAN MED PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

670 S GREEN VALLEY PKWY STE 100
HENDERSON NV
89052-0434
US

IV. Provider business mailing address

670 S GREEN VALLEY PKWY STE 100
HENDERSON NV
89052-0434
US

V. Phone/Fax

Practice location:
  • Phone: 725-262-4244
  • Fax:
Mailing address:
  • Phone: 725-262-4244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: HOVSEP STAMBULYAN
Title or Position: OWNER/PHYSICIAN
Credential: MD
Phone: 725-262-4244