Healthcare Provider Details

I. General information

NPI: 1558814889
Provider Name (Legal Business Name): DEVRAJ CHAVDA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2016
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6330 W FLAMINGO RD
LAS VEGAS NV
89103-2223
US

IV. Provider business mailing address

6330 W FLAMINGO RD
LAS VEGAS NV
89103-2223
US

V. Phone/Fax

Practice location:
  • Phone: 702-796-5505
  • Fax: 702-732-9830
Mailing address:
  • Phone: 702-796-5505
  • Fax: 702-732-9830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License Number21914
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number21914
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: