Individual
KHAIRALLAH FAYAZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1090 WIGWAM PKWY, STE 100, HENDERSON, NV 89074-8181
(702) 454-0201
Mailing address
1350 KELSO DUNES AVE APT 321, HENDERSON, NV 89014-7826
(702) 434-4967
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
11061
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001700084720
—
NV
Enumeration date
08/19/2006
Last updated
04/23/2008
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