=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982772349
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RAJAT SOOD MD LTD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/01/2006
-----------------------------------------------------
Last Update Date | 07/24/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2839 SAINT ROSE PKWY 130
-----------------------------------------------------
City | HENDERSON
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89052-4848
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-558-4027
-----------------------------------------------------
Fax | 702-921-9000
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2839 SAINT ROSE PKWY STE 130
-----------------------------------------------------
City | HENDERSON
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89052-4849
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-558-4027
-----------------------------------------------------
Fax | 702-558-4028
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. RAJAT SOOD
-----------------------------------------------------
Credential | M.D
-----------------------------------------------------
Telephone | 702-558-4027
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RG0100X
-----------------------------------------------------
Taxonomy Name | Gastroenterology Physician
-----------------------------------------------------
License Number | 8145
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------