Provider Demographics
NPI:1811783764
Name:SUN VALLEY WOUND SPECIALISTS PLLC
Entity type:Organization
Organization Name:SUN VALLEY WOUND SPECIALISTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IVA
Authorized Official - Middle Name:
Authorized Official - Last Name:TIRRES
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:972-955-2943
Mailing Address - Street 1:7316 E STETSON DR # 18
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-3406
Mailing Address - Country:US
Mailing Address - Phone:972-955-2943
Mailing Address - Fax:
Practice Address - Street 1:7316 E STETSON DR # 18
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-3406
Practice Address - Country:US
Practice Address - Phone:972-955-2943
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care