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General NPI Number Information
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NPI Number | 1760809818
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Entity Type | Individual
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Provider Name | SUBHASREE PANCHANGAM M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/26/2014
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 3131 LA CANADA ST STE 140
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City | LAS VEGAS
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State | NV
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Zip | 89169-2579
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Country | US
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Telephone | 702-933-9400
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Fax | 702-933-9444
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Provider Business Mailing Address
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Address Line | 6355 S BUFFALO DR FL 3
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City | LAS VEGAS
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State | NV
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Zip | 89113-2133
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Country | US
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Telephone | 702-216-3346
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | BP10061062
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 283694
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | NV
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Taxonomy #4
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 19099
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License Number State | NV
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