Healthcare Provider Details

I. General information

NPI: 1457334864
Provider Name (Legal Business Name): TANVIR AHMAD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2005
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7020 SMOKE RANCH RD SUITE 150
LAS VEGAS NV
89128-3111
US

IV. Provider business mailing address

7020 SMOKE RANCH RD SUITE 150
LAS VEGAS NV
89128-3111
US

V. Phone/Fax

Practice location:
  • Phone: 702-366-9522
  • Fax: 702-341-5206
Mailing address:
  • Phone: 702-258-1601
  • Fax: 702-870-1995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number7447
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number7447
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: