Organization
WESTERN VASCULAR INSTITUTE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL M TOM (CREDENTIALING OFFICER)
(480) 668-5000
Entity
Organization
Contact information
Practice address
7165 E UNIVERSITY DR STE 183, MESA, AZ 85207-6415
(480) 668-5000
(480) 668-5065
Mailing address
7165 E UNIVERSITY DR STE 187, MESA, AZ 85207-6415
(480) 668-5000
(480) 584-4289
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103899
—
AZ
05
—
414258
—
AZ
Enumeration date
10/11/2006
Last updated
01/21/2026
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