Organization
HOSPITALITY GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHANUKYA DASARI MD (OWNER)
(702) 800-8988
Entity
Organization
Contact information
Practice address
3175 SAINT ROSE PKWY, SUITE 230, HENDERSON, NV 89052-3506
(702) 602-6600
Mailing address
3175 SAINT ROSE PKWY, SUITE 230, HENDERSON, NV 89052-3506
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
16426
NV
Other
Enumeration date
05/05/2017
Last updated
05/05/2017
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