# NORTHWEST CARDIOVASCULAR AND THORACIC SURGEONS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336159185
- **Authorized official:** MRS. BONNIE J VAN DE WATER (OFFICE MANAGER)
- **Authorized official phone:** (623) 875-6001

## Contact information

- **Practice address:** 13188 N 103RD DR STE 200, SUN CITY, AZ 85351-3066
- **Practice address phone:** (623) 875-6001
- **Practice address fax:** (623) 875-8761
- **Mailing address:** 13188 N 103RD DR STE 200, SUN CITY, AZ 85351-3066
- **Mailing address phone:** (623) 875-6001
- **Mailing address fax:** (623) 875-8761

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | NULL | Yes |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/08/2006
- **Last updated:** 12/06/2007