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General NPI Number Information
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NPI Number | 1245698117
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Entity Type | Individual
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Provider Name | SAMIYAH M HOODBHOY PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/05/2016
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Last Update Date | 07/23/2018
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Provider Practice Location Address
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Address Line | 10001 S EASTERN AVE STE 108
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City | HENDERSON
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State | NV
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Zip | 89052
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Country | US
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Telephone | 702-952-3444
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Fax | 702-952-3494
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Provider Business Mailing Address
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Address Line | 400 N STEPHANIE ST STE 300
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City | HENDERSON
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State | NV
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Zip | 89014-6692
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Country | US
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Telephone | 702-952-3350
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Fax | 702-952-3364
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA1727
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License Number State | NV
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