Provider Demographics
NPI:1174757041
Name:PATIENTS FIRST MEDICAL LLC
Entity type:Organization
Organization Name:PATIENTS FIRST MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLD MBR
Authorized Official - Prefix:
Authorized Official - First Name:IYAD
Authorized Official - Middle Name:G
Authorized Official - Last Name:HOUSHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:1775-250-6161
Mailing Address - Street 1:10511 BROADHEAD CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89135
Mailing Address - Country:US
Mailing Address - Phone:775-250-6161
Mailing Address - Fax:702-382-5388
Practice Address - Street 1:10511 BROADHEAD CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89135-2323
Practice Address - Country:US
Practice Address - Phone:775-250-6161
Practice Address - Fax:702-382-5388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-07
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10568207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1497773287Medicaid
NV1497773287Medicaid