Healthcare Provider Details

I. General information

NPI: 1245343037
Provider Name (Legal Business Name): HAYDEE B DOCASAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 11/15/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6070 S FORT APACHE RD STE 100
LAS VEGAS NV
89148-5615
US

IV. Provider business mailing address

8255 LAS VEGAS BLVD S UNIT 309
LAS VEGAS NV
89123-1067
US

V. Phone/Fax

Practice location:
  • Phone: 702-550-4870
  • Fax: 855-898-8685
Mailing address:
  • Phone: 702-301-2111
  • Fax: 855-898-8685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number10887
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number10887
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: