Healthcare Provider Details

I. General information

NPI: 1407976376
Provider Name (Legal Business Name): BASSAM AL OWIR MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2423 PAVEENE AVE
HENDERSON NV
89052-6593
US

IV. Provider business mailing address

2423 PAVEENE AVE
HENDERSON NV
89052-6593
US

V. Phone/Fax

Practice location:
  • Phone: 702-210-5465
  • Fax:
Mailing address:
  • Phone: 702-210-5465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number10605
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BASSAM AL OWIR
Title or Position: PRESIDENT
Credential: MD
Phone: 702-210-5465