| Abraham T. Fakhouri, M.d. | |
|
861 Coronado Center Dr Ste 220 Henderson NV 89052-3992 | |
| (702) 933-1485 | |
| (702) 933-1490 |
| Full Name | Abraham T. Fakhouri, M.d. |
|---|---|
| Speciality | Family Medicine |
| Location | 861 Coronado Center Dr Ste 220, Henderson, Nevada |
| Authorized Official Name and Position | Abraham T. Fakhouri (MEMBER) |
| Authorized Official Contact | 7029331485 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Abraham T. Fakhouri, M.d. 861 Coronado Center Dr Ste 220 Henderson NV 89052-3992 Ph: () - | Abraham T. Fakhouri, M.d. 861 Coronado Center Dr Ste 220 Henderson NV 89052-3992 Ph: (702) 933-1485 |
| NPI Number | 1730691890 |
|---|---|
| Provider Enumeration Date | 10/30/2017 |
| Last Update Date | 01/04/2018 |
| Medicare PECOS PAC ID | 8628337201 |
|---|---|
| Medicare Enrollment ID | O20180201000838 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730691890 | NPI | - | NPPES |
| NV20171542901 | Other | NV | SOS BUSINESS LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 14038 (Nevada) | Primary |
| Provider Name | Nirav S Gandhi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881791564 PECOS PAC ID: 0042218497 Enrollment ID: I20061117000446 |
| Provider Name | Ibrahim Tawfiq Fakhouri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720248206 PECOS PAC ID: 6406028125 Enrollment ID: I20110930000353 |
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