Healthcare Provider Details

I. General information

NPI: 1821450545
Provider Name (Legal Business Name): SOUTHERN NEVADA BARIATRICS MUSTAFA AHMED MD FACS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2016
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2990 W HORIZON RIDGE PKWY STE 100
HENDERSON NV
89052-4663
US

IV. Provider business mailing address

2990 W HORIZON RIDGE PKWY STE 100
HENDERSON NV
89052-4663
US

V. Phone/Fax

Practice location:
  • Phone: 702-626-0499
  • Fax: 702-629-5038
Mailing address:
  • Phone: 702-626-0499
  • Fax: 702-629-5038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number15815
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number15815
License Number StateNV

VIII. Authorized Official

Name: MUSTAFA I AHMED
Title or Position: PRESIDENT
Credential: MD
Phone: 702-626-0499