Provider Demographics
NPI:1437645256
Name:DEPERALTA, MYRA RASHMI (MD)
Entity type:Individual
Prefix:
First Name:MYRA
Middle Name:RASHMI
Last Name:DEPERALTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MYRA
Other - Middle Name:RASHMI
Other - Last Name:SHAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6040 S FORT APACHE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-5613
Mailing Address - Country:US
Mailing Address - Phone:702-476-4900
Mailing Address - Fax:702-476-4949
Practice Address - Street 1:6040 S FORT APACHE RD STE 100
Practice Address - Street 2:SUITE 100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-5613
Practice Address - Country:US
Practice Address - Phone:702-476-4900
Practice Address - Fax:702-476-4949
Is Sole Proprietor?:No
Enumeration Date:2018-07-04
Last Update Date:2025-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV22606207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine