Provider Demographics
NPI:1275683294
Name:YOUSSEF, AMEL Y (OD)
Entity Type:Individual
Prefix:
First Name:AMEL
Middle Name:Y
Last Name:YOUSSEF
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 FESTIVAL PLAZA DR
Mailing Address - Street 2:STE 195
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89135-1455
Mailing Address - Country:US
Mailing Address - Phone:702-858-4362
Mailing Address - Fax:702-920-8787
Practice Address - Street 1:2010 FESTIVAL PLAZA DR
Practice Address - Street 2:STE 195
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89135-1455
Practice Address - Country:US
Practice Address - Phone:702-858-4362
Practice Address - Fax:702-920-8787
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV449152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVCS19117OtherCONTROLLED SUBSTANCE CERTIFICATE
NVCS19117OtherCONTROLLED SUBSTANCE CERTIFICATE