MEDICARE: ACCIDENT & INJURY PAIN CENTERS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1457401135
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCIDENT & INJURY PAIN CENTERS, INC.

Provider Business Mailing Address
First Line	:	200 WYNNEWOOD VILLAGE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75224
Country	:	US
Telephone Number	:	214-378-4499
Fax Number	:	214-948-6576

Provider Business Practice Location Address
First Line	:	1504 PENNSYLVANIA AVE
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76104-2027
Country	:	US
Telephone Number	:	817-335-4878
Fax Number	:	817-335-4890

Authorized Official
Title or Position	:	CHIEF OF STAFF
Name	:	DR. THOMAS RHUDY
Credential	:	DC
Telephone Number	:	214-378-4499

Provider Enumeration Date	:	01/12/2007
Last Update Date	:	08/22/2020

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