MEDICARE: BREAST HEALTH MEDICAL SERVICES PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518037142
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BREAST HEALTH MEDICAL SERVICES PLLC

Provider Business Mailing Address
First Line	:	400 N STEPHANIE ST
Second Line	:	SUITE 300
City	:	HENDERSON
State	:	NV
Zip	:	89014-6676
Country	:	US
Telephone Number	:	702-255-1133
Fax Number	:	702-255-0582

Provider Business Practice Location Address
First Line	:	8285 W ARBY AVE STE 231
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-2236
Country	:	US
Telephone Number	:	702-255-1133
Fax Number	:	702-255-0582

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	SOUZAN EZZAT EL-EID
Credential	:	MD
Telephone Number	:	702-255-1133

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	03/29/2013

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Directions to “BREAST HEALTH MEDICAL SERVICES PLLC ” Practice Location

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