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General NPI Number Information
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NPI Number | 1598381543
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Entity Type | Individual
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Provider Name | AVNEET PUREWAL OD
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Gender | Female
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Dates
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Enumeration Date | 06/24/2020
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Last Update Date | 06/24/2020
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Provider Practice Location Address
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Address Line | 1000 N GREEN VALLEY PKWY STE 420
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City | HENDERSON
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State | NV
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Zip | 89074-6172
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Country | US
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Telephone | 312-358-5250
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Fax |
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Provider Business Mailing Address
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Address Line | 14-23330 TOWNSHIP ROAD 522
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City | SHERWOOD PARK
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State | ALBERTA
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Zip | T8B1H8
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Country | CA
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Telephone |
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Fax |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1068
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License Number State | NV
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