1275912669 NPI number — ZEN INTERVENTIONAL PAIN AND WELLNESS CENTER PLLC

Table of content: (NPI 1275912669)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275912669 NPI number — ZEN INTERVENTIONAL PAIN AND WELLNESS CENTER PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ZEN INTERVENTIONAL PAIN AND WELLNESS CENTER PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
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Provider Other Name Prefix Text:
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Provider Other Credential Text:
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NPI Number Information

NPI Number:
1275912669
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/19/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1700 CEDAR SPRINGS RD
Provider Second Line Business Mailing Address:
2401
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75202-1203
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1115 E ARKANSAS LN
Provider Second Line Business Practice Location Address:
B
Provider Business Practice Location Address City Name:
ARLINGTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76010-6415
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-476-0030
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/19/2015

Additional Information

Authorized Official

Authorized Official Last Name:
ROZIER
Authorized Official First Name:
ANTONIO
Authorized Official Middle Name:
Authorized Official Title or Position:
FOUNDER/CEO
Authorized Official Telephone Number:
817-476-0030

Provider Taxonomy Codes

  • Taxonomy code: 261QP3300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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