Healthcare Provider Details
I. General information
NPI: 1760426001
Provider Name (Legal Business Name): WESTERN VASCULAR INSTITUTE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/16/2006
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7165 E UNIVERSITY DR STE 183
MESA AZ
85207-6415
US
IV. Provider business mailing address
7165 E UNIVERSITY DR STE 187
MESA AZ
85207-6415
US
V. Phone/Fax
- Phone: 480-668-5000
- Fax: 480-668-5065
- Phone: 480-668-5000
- Fax: 480-668-5065
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0129X |
| Taxonomy | Vascular Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
HENRY
TARLIAN
Title or Position: PARTNER
Credential: MD
Phone: 480-668-5000