Provider Demographics
NPI:1467737858
Name:ZAHEDI, BESHAD
Entity Type:Individual
Prefix:
First Name:BESHAD
Middle Name:
Last Name:ZAHEDI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1360 W HORIZON RIDGE PKWY
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-2462
Mailing Address - Country:US
Mailing Address - Phone:702-568-9459
Mailing Address - Fax:702-568-9729
Practice Address - Street 1:1360 W HORIZON RIDGE PKWY
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89012-2462
Practice Address - Country:US
Practice Address - Phone:702-568-9459
Practice Address - Fax:702-568-9729
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-17
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV16947183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist