Healthcare Provider Details

I. General information

NPI: 1952533887
Provider Name (Legal Business Name): QURESHI AL-OWIR PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2009
Last Update Date: 05/04/2022
Certification Date: 11/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 MALL RING CIR STE 202
HENDERSON NV
89014-6667
US

IV. Provider business mailing address

PO BOX 92062
LAS VEGAS NV
89193-2062
US

V. Phone/Fax

Practice location:
  • Phone: 702-483-6200
  • Fax: 702-483-6202
Mailing address:
  • Phone: 702-483-6200
  • Fax: 702-483-6202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number3264
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number10605
License Number StateNV

VIII. Authorized Official

Name: BASSAM AL-OWIR
Title or Position: MANAGER
Credential: MD
Phone: 702-483-6200