# ENVI PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396145264
- **Authorized official:** DR. ASAD EHTISHAM MD (OWNER)
- **Authorized official phone:** (623) 300-3684

## Contact information

- **Practice address:** 15396 N 83RD AVE STE E, PEORIA, AZ 85381-5627
- **Practice address phone:** (623) 300-3684
- **Practice address fax:** (602) 671-3684
- **Mailing address:** 15396 N 83RD AVE STE E, PEORIA, AZ 85381-5627

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084N0400X | Neurology Physician | — | NULL | — |
| 2084N0400X | Neurology Physician | — | — | — |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/28/2014
- **Last updated:** 10/20/2020