1841487113 NPI number — BILIANA M DARZEV MD LTD

Table of content: (NPI 1841487113)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841487113 NPI number — BILIANA M DARZEV MD LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BILIANA M DARZEV MD LTD
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:
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:
1841487113
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/13/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
653 N TOWN CENTER DR STE 300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89144-0517
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-456-7255
Provider Business Mailing Address Fax Number:
702-456-7855

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
653 N TOWN CENTER DR
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89144-0514
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-456-7255
Provider Business Practice Location Address Fax Number:
702-456-7855
Provider Enumeration Date:
10/01/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DARZEV
Authorized Official First Name:
BILIANA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
702-456-7255

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , with the licence number:  NV9843 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 002018490 , issued by the state of ( NV ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com