Healthcare Provider Details

I. General information

NPI: 1861783961
Provider Name (Legal Business Name): SHELIN AGRAWAL AND HYER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2011
Last Update Date: 07/12/2024
Certification Date: 07/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 PALOMINO LN SUITE 100
LAS VEGAS NV
89106-4894
US

IV. Provider business mailing address

PO BOX 1465
INDIANAPOLIS IN
46206-1465
US

V. Phone/Fax

Practice location:
  • Phone: 702-759-8600
  • Fax: 702-384-1815
Mailing address:
  • Phone: 702-759-8600
  • Fax: 702-384-1815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License NumberNV20111211914
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License NumberNV20111211914
License Number StateNV
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberNV20111211914
License Number StateNV

VIII. Authorized Official

Name: SHARLEE LEBLEU
Title or Position: VICE PRESIDENT
Credential:
Phone: 480-321-7026