Provider Demographics
NPI:1831506575
Name:MASOOD, AHMED (APH)
Entity type:Individual
Prefix:MR
First Name:AHMED
Middle Name:
Last Name:MASOOD
Suffix:
Gender:M
Credentials:APH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1580 E DESERT INN RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89169-2548
Mailing Address - Country:US
Mailing Address - Phone:702-836-3442
Mailing Address - Fax:702-836-9367
Practice Address - Street 1:1580 EAST DESERT INN ROAD, SUITE 200
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89169
Practice Address - Country:US
Practice Address - Phone:702-836-3442
Practice Address - Fax:702-836-9367
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-15
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV103K00000X
NVA81311175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No175L00000XOther Service ProvidersHomeopath