Provider Demographics
NPI:1265906937
Name:ENAYAT ENDOCRINOLOGY AND METABOLISM, PLLC
Entity type:Organization
Organization Name:ENAYAT ENDOCRINOLOGY AND METABOLISM, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMIM
Authorized Official - Middle Name:
Authorized Official - Last Name:ENAYAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-272-2792
Mailing Address - Street 1:10105 BANBURRY CROSS DR STE 130
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89144-6642
Mailing Address - Country:US
Mailing Address - Phone:702-272-2792
Mailing Address - Fax:
Practice Address - Street 1:10105 BANBURRY CROSS DR STE 130
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89144-6642
Practice Address - Country:US
Practice Address - Phone:615-879-0587
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-16
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty