Healthcare Provider Details

I. General information

NPI: 1851439558
Provider Name (Legal Business Name): DAULAT LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 02/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3416 N BUFFALO DR
LAS VEGAS NV
89129-7424
US

IV. Provider business mailing address

39 DRIFTING SHADOW WAY
LAS VEGAS NV
89135-7879
US

V. Phone/Fax

Practice location:
  • Phone: 702-565-4917
  • Fax: 702-562-8680
Mailing address:
  • Phone: 702-565-4917
  • Fax: 702-562-8680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. SARITA DAULAT
Title or Position: OFFICE MANAGER
Credential:
Phone: 702-565-4917