Healthcare Provider Details

I. General information

NPI: 1497993844
Provider Name (Legal Business Name): INTERVENTIONAL PAIN SPECIALISTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2009
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3983 I 49 S SERVICE RD
OPELOUSAS LA
70570-0758
US

IV. Provider business mailing address

PO BOX 69
OPELOUSAS LA
70571-0069
US

V. Phone/Fax

Practice location:
  • Phone: 337-284-3200
  • Fax: 800-207-6956
Mailing address:
  • Phone: 337-284-3200
  • Fax: 800-207-6956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number StateLA

VIII. Authorized Official

Name: DR. ALBERT J GROS
Title or Position: PHYSICIAN OWNER/MANAGER
Credential: MD
Phone: 337-284-3200