Provider Demographics
NPI:1962504126
Name:SOOD, RAJAT (MD)
Entity Type:Individual
Prefix:DR
First Name:RAJAT
Middle Name:
Last Name:SOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2654 W HORIZON RIDGE PKWY
Mailing Address - Street 2:B-5 #167
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-2803
Mailing Address - Country:US
Mailing Address - Phone:702-558-4027
Mailing Address - Fax:702-558-4028
Practice Address - Street 1:2839 SAINT ROSE PKWY STE 130
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4849
Practice Address - Country:US
Practice Address - Phone:702-558-4027
Practice Address - Fax:702-558-4028
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8145207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002019854Medicaid
NVF15169Medicare UPIN
NVV103080Medicare PIN