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General NPI Number Information
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NPI Number | 1891143806
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Entity Type | Organization
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Legal Business Name | DYNAMIC URGENT CARE
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Dates
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Enumeration Date | 05/31/2016
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Last Update Date | 08/04/2016
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Provider Practice Location Address
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Address Line | 2435 FIRE MESA ST STE 120
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City | LAS VEGAS
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State | NV
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Zip | 89128-9009
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Country | US
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Telephone | 725-200-3232
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Fax | 725-200-3233
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Provider Business Mailing Address
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Address Line | 2435 FIRE MESA ST STE 120
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City | LAS VEGAS
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State | NV
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Zip | 89128-9009
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Country | US
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Telephone | 725-200-3232
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Fax | 725-200-3233
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | DR. DHAVAL SHAH
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Credential | M.D.
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Telephone | 725-200-3232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 12305
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License Number State | NV
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