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General NPI Number Information
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NPI Number | 1447449269
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Entity Type | Organization
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Legal Business Name | TAREQ JAMIL MD, PC
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Dates
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Enumeration Date | 10/17/2007
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Last Update Date | 10/17/2007
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Provider Practice Location Address
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Address Line | 653 N TOWN CENTER DR SUITE #202
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City | LAS VEGAS
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State | NV
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Zip | 89144-0514
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Country | US
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Telephone | 702-233-6694
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Fax | 702-233-0485
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Provider Business Mailing Address
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Address Line | 2809 CRYSTAL BEACH DR
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City | LAS VEGAS
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State | NV
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Zip | 89128-6908
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Country | US
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Telephone | 702-477-5874
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Fax | 702-430-8419
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Authorized Official
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Title or Position | PRESEDENT
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Name | TAREQ JAMIL
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Credential | MD
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Telephone | 702-477-5874
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 10292
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 10292
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License Number State | NV
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