Healthcare Provider Details

I. General information

NPI: 1669583175
Provider Name (Legal Business Name): NAIYERA PARWEEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 02/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10410 S EASTERN AVE SUITE #100
HENDERSON NV
89052-4195
US

IV. Provider business mailing address

861 CORONADO CENTER DR STE 211
HENDERSON NV
89052-3992
US

V. Phone/Fax

Practice location:
  • Phone: 702-914-7150
  • Fax: 702-914-1924
Mailing address:
  • Phone: 702-407-8241
  • Fax: 702-492-1728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number10660
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: