| |
7440 N Oracle Rd Bldg 4, Tucson, AZ 85704-6378 | |
(520) 308-5289 | |
(520) 989-3025 |
Full Name | |
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Type | Facility |
Speciality | Nurse Practitioner - Psychiatric/mental Health |
Location | 7440 N Oracle Rd Bldg 4, Tucson, Arizona |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1386252351 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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171100000X | Acupuncturist | (* (Not Available)) | Secondary |
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
Provider Name | Herald Surya |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083811665 PECOS PAC ID: 1759644206 Enrollment ID: I20180413001971 |
Mailing Address | Practice Location Address |
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60568 E Eagle Ridge Dr, Tucson, AZ 85739-5945 Ph: (786) 908-6166 | 7440 N Oracle Rd Bldg 4, Tucson, AZ 85704-6378 Ph: (520) 308-5289 |