Healthcare Provider Details

I. General information

NPI: 1487830261
Provider Name (Legal Business Name): THE HEADACHE & PAIN CENTER, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2008
Last Update Date: 02/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8101 W 135TH ST SUITE 200
OVERLAND PARK KS
66223-1111
US

IV. Provider business mailing address

8101 W 135TH ST STE 200
OVERLAND PARK KS
66223-1111
US

V. Phone/Fax

Practice location:
  • Phone: 913-491-3999
  • Fax: 913-387-3156
Mailing address:
  • Phone: 913-491-3999
  • Fax: 913-387-3156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberS046003
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberS046025
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberS046003
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberS046025
License Number StateKS

VIII. Authorized Official

Name: DR. MAURICIO GARCIA
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 913-491-3999