Provider Demographics
NPI:1982763108
Name:HESHAM SIRSY MD LTD
Entity Type:Organization
Organization Name:HESHAM SIRSY MD LTD
Other - Org Name:ABC PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HESHAM
Authorized Official - Middle Name:AL
Authorized Official - Last Name:SIRSY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-614-2192
Mailing Address - Street 1:10950 S EASTERN AVE
Mailing Address - Street 2:#100
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4970
Mailing Address - Country:US
Mailing Address - Phone:702-614-2192
Mailing Address - Fax:702-614-2190
Practice Address - Street 1:10950 S EASTERN AVE
Practice Address - Street 2:#100
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4970
Practice Address - Country:US
Practice Address - Phone:702-614-2192
Practice Address - Fax:702-614-2190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2009-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7291208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2019371Medicaid
NV3102371Medicaid