Provider Demographics
NPI:1003660051
Name:UNITED THERANOSTICS PHYSICIANS OF ARIZONA, PC
Entity Type:Organization
Organization Name:UNITED THERANOSTICS PHYSICIANS OF ARIZONA, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BABAK
Authorized Official - Middle Name:
Authorized Official - Last Name:SABOURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-431-1898
Mailing Address - Street 1:8300 NORMAN CENTER DR STE 160
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55437-1028
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:22455 N MILLER RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-4956
Practice Address - Country:US
Practice Address - Phone:612-431-1898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear MedicineGroup - Multi-Specialty