Provider Demographics
NPI:1679929921
Name:LALL, ALEX PARAM (MD)
Entity type:Individual
Prefix:MR
First Name:ALEX
Middle Name:PARAM
Last Name:LALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8930 W SUNSET RD STE 300
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-5013
Mailing Address - Country:US
Mailing Address - Phone:702-258-7788
Mailing Address - Fax:
Practice Address - Street 1:8930 W SUNSET RD STE 300
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-5013
Practice Address - Country:US
Practice Address - Phone:702-258-7788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-05
Last Update Date:2024-10-09
Deactivation Date:2017-01-03
Deactivation Code:
Reactivation Date:2017-04-20
Provider Licenses
StateLicense IDTaxonomies
NV260032086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery