1740632819 NPI number — HAYAT JAWADI DO PLLC

Table of content: BETTY JANE KEMPER CRNA (NPI 1033155205)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740632819 NPI number — HAYAT JAWADI DO PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HAYAT JAWADI DO PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740632819
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/16/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2880 BICENTENNIAL PKWY
Provider Second Line Business Mailing Address:
STE 100 # 200
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89044-4483
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-834-7300
Provider Business Mailing Address Fax Number:
702-902-2400

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3041 W HORIZON RIDGE PKWY STE 165
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HENDERSON
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89052-5061
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-834-7300
Provider Business Practice Location Address Fax Number:
702-902-2400
Provider Enumeration Date:
07/12/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
JAWADI
Authorized Official First Name:
HAYAT
Authorized Official Middle Name:
Authorized Official Title or Position:
MNG MEMBER
Authorized Official Telephone Number:
702-834-7300

Provider Taxonomy Codes

  • Taxonomy code: 207VG0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)