Healthcare Provider Details
I. General information
NPI: 1730137480
Provider Name (Legal Business Name): PIMA HEART PHYSICIANS, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/05/2006
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2404 E RIVER RD STE 100
TUCSON AZ
85718-6521
US
IV. Provider business mailing address
2404 E RIVER RD STE 100
TUCSON AZ
85718-6521
US
V. Phone/Fax
- Phone: 520-838-3540
- Fax: 520-325-3526
- Phone: 520-838-3540
- Fax: 520-325-3526
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0001X |
| Taxonomy | Clinical Cardiac Electrophysiology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RI0011X |
| Taxonomy | Interventional Cardiology Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0129X |
| Taxonomy | Vascular Surgery Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208G00000X |
| Taxonomy | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOHN
UNDERWOOD
Title or Position: VP TREASURER
Credential:
Phone: 817-948-3428