# CIDS FAMILY PRACTICE

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DHAVAL SHAH MD PC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1811416530
- **Legal business name:** DHAVAL SHAH MD PC
- **Authorized official:** PAGE MCCALISTER (BILLING & CREDENTIALING MANAGER)
- **Authorized official phone:** (725) 200-3232

## Contact information

- **Practice address:** 2435 FIRE MESA ST STE 110, LAS VEGAS, NV 89128-9009
- **Practice address phone:** (725) 200-3242
- **Practice address fax:** (725) 200-3244
- **Mailing address:** 2435 FIRE MESA ST STE 120, LAS VEGAS, NV 89128-9009
- **Mailing address phone:** (702) 968-2437

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207K00000X | Allergy & Immunology Physician | — | NULL | — |
| 207K00000X | Allergy & Immunology Physician | — | — | — |
| 207QA0505X | Adult Medicine Physician | — | NULL | Yes |
| 207QA0505X | Adult Medicine Physician | — | — | Yes |
| 213E00000X | Podiatrist | — | NULL | — |
| 213E00000X | Podiatrist | — | — | — |

## Other

- **Enumeration date:** 09/13/2017
- **Last updated:** 02/14/2019