Healthcare Provider Details

I. General information

NPI: 1912717828
Provider Name (Legal Business Name): HEART, LUNG, AND VASCULAR SURGERY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2025
Last Update Date: 01/13/2025
Certification Date: 01/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4445 S EASTERN AVE STE 1
LAS VEGAS NV
89119-7851
US

IV. Provider business mailing address

2736 KILDRUMMIE ST
HENDERSON NV
89044-0235
US

V. Phone/Fax

Practice location:
  • Phone: 702-902-0885
  • Fax:
Mailing address:
  • Phone: 702-902-0885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ASHRAF I. OSMAN
Title or Position: CEO&PRESIDENT
Credential: MD
Phone: 702-902-0885