Healthcare Provider Details

I. General information

NPI: 1316579915
Provider Name (Legal Business Name): BILL NASSAR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2020
Last Update Date: 02/11/2020
Certification Date: 02/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3663 E SUNSET RD STE 104B
LAS VEGAS NV
89120-3218
US

IV. Provider business mailing address

3663 E SUNSET RD STE 104B
LAS VEGAS NV
89120-3218
US

V. Phone/Fax

Practice location:
  • Phone: 702-832-7921
  • Fax: 702-881-4033
Mailing address:
  • Phone: 702-832-7921
  • Fax: 702-881-4033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: