Healthcare Provider Details

I. General information

NPI: 1356152250
Provider Name (Legal Business Name): T&R PHYSICIANS GROUP, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2025
Last Update Date: 01/20/2025
Certification Date: 01/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6890 E SUNRISE DR # 120-393
TUCSON AZ
85750-0738
US

IV. Provider business mailing address

6890 E SUNRISE DR # 120-393
TUCSON AZ
85750-0738
US

V. Phone/Fax

Practice location:
  • Phone: 520-485-3431
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. ALAN GOODSTAT
Title or Position: VP OF COMPLIANCE
Credential: LCSW
Phone: 954-415-0758