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General NPI Number Information
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NPI Number | 1700868155
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Entity Type | Individual
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Provider Name | KEVIN C XIE MD
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Gender | Male
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Dates
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Enumeration Date | 11/18/2005
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Last Update Date | 09/08/2020
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Provider Practice Location Address
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Address Line | 5115 S DURANGO DR
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City | LAS VEGAS
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State | NV
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Zip | 89113-0189
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Country | US
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Telephone | 320-333-0789
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Fax |
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Provider Business Mailing Address
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Address Line | 12117 PASEO TERRAZA LN
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City | LAS VEGAS
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State | NV
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Zip | 89138-1125
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Country | US
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Telephone | 320-333-0789
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 42789
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 16692
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License Number State | NV
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