Healthcare Provider Details

I. General information

NPI: 1093465916
Provider Name (Legal Business Name): SHIRZAD SHIR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2022
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6080 N LA CHOLLA BLVD STE A
TUCSON AZ
85741-3555
US

IV. Provider business mailing address

6080 N LA CHOLLA BLVD STE A
TUCSON AZ
85741-3555
US

V. Phone/Fax

Practice location:
  • Phone: 520-593-6875
  • Fax: 520-545-0579
Mailing address:
  • Phone:
  • Fax: 520-545-0579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: