Provider Demographics
NPI:1336301662
Name:HADIZA E HAMZA MD A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:HADIZA E HAMZA MD A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HADIZA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-805-5410
Mailing Address - Street 1:PO BOX 50878
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89016-0878
Mailing Address - Country:US
Mailing Address - Phone:702-805-5410
Mailing Address - Fax:702-342-1385
Practice Address - Street 1:1730 W HORIZON RIDGE PKWY STE 100
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89012-1000
Practice Address - Country:US
Practice Address - Phone:702-805-5410
Practice Address - Fax:702-342-1385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-27
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10125207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVH69247Medicare UPIN
NVV106132Medicare PIN