Provider Demographics
NPI:1720393341
Name:DIGESTIVE HEALTH ASSOCIATES, LLC
Entity Type:Organization
Organization Name:DIGESTIVE HEALTH ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KHALED
Authorized Official - Middle Name:
Authorized Official - Last Name:NOUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-829-8855
Mailing Address - Street 1:5250 KIETZKE LN
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-2037
Mailing Address - Country:US
Mailing Address - Phone:775-829-8855
Mailing Address - Fax:775-829-3752
Practice Address - Street 1:5250 KIETZKE LN
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2037
Practice Address - Country:US
Practice Address - Phone:775-829-8855
Practice Address - Fax:775-829-3752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-09
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty