1053103747 NPI number — RICHMOND SPINE INTERVENTIONS AND PAIN CENTER, PC

Table of content: OSCAR FRANCISCO CERVANTES JR. (NPI 1164280699)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053103747 NPI number — RICHMOND SPINE INTERVENTIONS AND PAIN CENTER, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RICHMOND SPINE INTERVENTIONS AND PAIN CENTER, PC
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:
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:
1053103747
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/20/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3420 PUMP RD # 160
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HENRICO
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23233-1111
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-426-4422
Provider Business Mailing Address Fax Number:
804-378-5400

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1011 JOHNSTON WILLIS DR STE 230
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH CHESTERFIELD
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23235-4808
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-378-1800
Provider Business Practice Location Address Fax Number:
804-378-5400
Provider Enumeration Date:
05/20/2025

Additional Information

Authorized Official

Authorized Official Last Name:
NAZMI
Authorized Official First Name:
PEYMAN
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
804-378-1800

Provider Taxonomy Codes

  • Taxonomy code: 208VP0014X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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