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General NPI Number Information
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NPI Number | 1699666255
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Entity Type | Organization
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Legal Business Name | SONORAN VEIN AND ENDOVASCULAR LLC
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Dates
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Enumeration Date | 07/11/2025
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 9192 W UNION HILLS DR
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City | PEORIA
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State | AZ
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Zip | 85382-8208
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Country | US
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Telephone | 602-374-4101
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Fax | 602-441-0522
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Provider Business Mailing Address
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Address Line | 9192 W UNION HILLS DR
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City | PEORIA
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State | AZ
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Zip | 85382-8208
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Country | US
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Telephone | 602-374-4101
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Fax | 602-441-0522
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Authorized Official
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Title or Position | CMO
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Name | DAVID NYE
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Credential | DO
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Telephone | 480-363-7778
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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