Provider Demographics
NPI:1457149114
Name:MYRZA, DAVID (PHMNP)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:MYRZA
Suffix:
Gender:
Credentials:PHMNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8320 W CATALINA DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85037-3344
Mailing Address - Country:US
Mailing Address - Phone:916-897-1340
Mailing Address - Fax:
Practice Address - Street 1:8320 W CATALINA DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-3344
Practice Address - Country:US
Practice Address - Phone:916-897-1340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ218842363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health