Healthcare Provider Details

I. General information

NPI: 1437179306
Provider Name (Legal Business Name): BRIAN L STRAUSS MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4230 BURNHAM AVE
LAS VEGAS NV
89119-5408
US

IV. Provider business mailing address

975 SEVEN HILLS DR APT 4421
HENDERSON NV
89052-4314
US

V. Phone/Fax

Practice location:
  • Phone: 702-733-3704
  • Fax:
Mailing address:
  • Phone: 702-461-3010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number108561
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: