Provider Demographics
NPI:1144922105
Name:DE VERA, ADRIAN ZACHARY CU (MD)
Entity type:Individual
Prefix:DR
First Name:ADRIAN ZACHARY
Middle Name:CU
Last Name:DE VERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ADRIAN
Other - Middle Name:CU
Other - Last Name:DEVERA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3014 W CHARLESTON BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-2021
Mailing Address - Country:US
Mailing Address - Phone:702-561-3378
Mailing Address - Fax:
Practice Address - Street 1:3014 W CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-2021
Practice Address - Country:US
Practice Address - Phone:702-561-3378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-21
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVLL39722084P0800X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry