Basic Information
Provider Information
NPI: 1144392903
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VYAS
FirstName: CHIRAG
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 15645
Address2:  
City: LAS VEGAS
State: NV
PostalCode: 891145645
CountryCode: US
TelephoneNumber: 7026171227
FaxNumber: 7026162069
Practice Location
Address1: 2825 SIENA HEIGHTS DR
Address2:  
City: HENDERSON
State: NV
PostalCode: 890523976
CountryCode: US
TelephoneNumber: 7026171227
FaxNumber: 7026162069
Other Information
ProviderEnumerationDate: 11/15/2006
LastUpdateDate: 03/04/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X236974NYN Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 
207V00000XN4826NVY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

ID Information
IDTypeStateIssuerDescription
114439290305NV MEDICAID


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