Healthcare Provider Details

I. General information

NPI: 1407164486
Provider Name (Legal Business Name): AZTEC PATHOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2010
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5024 S ASH AVE STE 103
TEMPE AZ
85282-6847
US

IV. Provider business mailing address

5024 S ASH AVE STE 103
TEMPE AZ
85282-6847
US

V. Phone/Fax

Practice location:
  • Phone: 623-806-1500
  • Fax: 623-433-0174
Mailing address:
  • Phone: 623-806-1500
  • Fax: 623-433-0174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. SHVETA MEHRA
Title or Position: PRESIDENT
Credential: MD
Phone: 623-806-1500