1013038801 NPI number — PAIN AND ANESTHESIA ASSOCIATES, PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013038801 NPI number — PAIN AND ANESTHESIA ASSOCIATES, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PAIN AND ANESTHESIA ASSOCIATES, 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:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013038801
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/25/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5700 NORTH EXPRESSWAY 77/83
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
BROWNSVILLE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78520
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-350-0900
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5700 NORTH EXPRESSWAY 77/83
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
BROWNSVILLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78520
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-350-0900
Provider Business Practice Location Address Fax Number:
956-350-0909
Provider Enumeration Date:
04/02/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WORLEY
Authorized Official First Name:
CYNTHIA
Authorized Official Middle Name:
Authorized Official Title or Position:
ACCOUNTANT
Authorized Official Telephone Number:
956-440-7246

Provider Taxonomy Codes

  • Taxonomy code: 207LP2900X , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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