Healthcare Provider Details

I. General information

NPI: 1114870649
Provider Name (Legal Business Name): SEVA PAIN AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2026
Last Update Date: 02/16/2026
Certification Date: 02/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

353 E LA ENTRADA
CORRALES NM
87048-7647
US

IV. Provider business mailing address

PO BOX 293854
LEWISVILLE TX
75029-3854
US

V. Phone/Fax

Practice location:
  • Phone: 505-431-2501
  • Fax: 505-431-2502
Mailing address:
  • Phone: 918-935-3240
  • Fax: 918-935-3241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: AMIT MIRCHANDANI
Title or Position: OWNER
Credential: MD
Phone: 901-289-4227