Healthcare Provider Details

I. General information

NPI: 1538087846
Provider Name (Legal Business Name): SAMAH ALNATOUR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4440 S EASTERN AVE
LAS VEGAS NV
89119-7825
US

IV. Provider business mailing address

4440 S EASTERN AVE
LAS VEGAS NV
89119-7825
US

V. Phone/Fax

Practice location:
  • Phone: 702-444-0599
  • Fax:
Mailing address:
  • Phone: 702-444-0599
  • Fax: 702-444-4877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License NumberCHW1-6164
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: