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Organization
ENVI PLLC
Active
Organization
ENVI PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ASAD EHTISHAM MD (OWNER)
(623) 300-3684
Entity
Organization
Contact information
Practice address
15396 N 83RD AVE STE E, PEORIA, AZ 85381-5627
(623) 300-3684
(602) 671-3684
Mailing address
15396 N 83RD AVE STE E, PEORIA, AZ 85381-5627
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
—
NULL
2084N0400X
Neurology Physician
—
—
261QM2500X
Medical Specialty Clinic/Center
Primary
—
NULL
Other
Enumeration date
08/28/2014
Last updated
10/20/2020
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