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General NPI Number Information
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NPI Number | 1043490170
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Entity Type | Organization
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Legal Business Name | SYED PERVAIZ MD LLC
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Dates
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Enumeration Date | 11/06/2007
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Last Update Date | 10/07/2019
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Provider Practice Location Address
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Address Line | 2610 W HORIZON RIDGE PKWY SUITE 103
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City | HENDERSON
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State | NV
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Zip | 89052-2869
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Country | US
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Telephone | 702-693-6222
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Fax | 702-492-6816
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Provider Business Mailing Address
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Address Line | 4161 S. EASTERN AVE SUITE B3
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City | LAS VEGAS
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State | NV
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Zip | 89119
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Country | US
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Telephone | 702-693-6222
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Fax | 702-492-6816
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SYED PERVAIZ
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Credential | MD
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Telephone | 702-498-7706
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 11875
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License Number State | NV
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