Healthcare Provider Details

I. General information

NPI: 1649585472
Provider Name (Legal Business Name): TANYA THOMS, DPM PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2010
Last Update Date: 08/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13629 W CAMINO DEL SOL SUITE 150
SUN CITY WEST AZ
85375-1405
US

IV. Provider business mailing address

PO BOX 11163
GLENDALE AZ
85318-1163
US

V. Phone/Fax

Practice location:
  • Phone: 623-584-6500
  • Fax: 623-584-6335
Mailing address:
  • Phone: 623-584-6500
  • Fax: 623-584-6335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number0658
License Number StateAZ

VIII. Authorized Official

Name: TANYA L. THOMS
Title or Position: MANAGING EMPLOYEE
Credential: DPM
Phone: 623-584-6500