Provider Demographics
NPI:1841911054
Name:BILAL, QURAN
Entity type:Individual
Prefix:
First Name:QURAN
Middle Name:
Last Name:BILAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:DESERT RUN LLC
Other - Middle Name:
Other - Last Name:COMPANY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:7352 LIONHEART ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-1185
Mailing Address - Country:US
Mailing Address - Phone:702-969-2100
Mailing Address - Fax:
Practice Address - Street 1:7352 LIONHEART ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-1185
Practice Address - Country:US
Practice Address - Phone:702-969-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV76160A347B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347B00000XTransportation ServicesBus