Provider Demographics
NPI:1316537632
Name:NASSAR, SAMIR BILL
Entity Type:Individual
Prefix:MR
First Name:SAMIR
Middle Name:BILL
Last Name:NASSAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3663 E SUNSET RD STE 201A
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-3246
Mailing Address - Country:US
Mailing Address - Phone:702-881-4033
Mailing Address - Fax:702-780-4441
Practice Address - Street 1:3663 E SUNSET RD STE 201A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3246
Practice Address - Country:US
Practice Address - Phone:702-881-4033
Practice Address - Fax:702-780-4441
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103TH0100X343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)