Provider Demographics
NPI:1487425120
Name:TAWIL, TAREK FUAD (DC, CTP)
Entity type:Individual
Prefix:DR
First Name:TAREK
Middle Name:FUAD
Last Name:TAWIL
Suffix:
Gender:M
Credentials:DC, CTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3737 PECOS MCLEOD STE 101
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-4263
Mailing Address - Country:US
Mailing Address - Phone:702-369-5436
Mailing Address - Fax:
Practice Address - Street 1:3737 PECOS MCLEOD STE 101
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-4263
Practice Address - Country:US
Practice Address - Phone:702-369-5436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-11
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC36794111N00000X
NV202200389332800000X
NVB02041111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractor
No332800000XSuppliersIndian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy