Healthcare Provider Details

I. General information

NPI: 1679916688
Provider Name (Legal Business Name): NEUROPAIN SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2013
Last Update Date: 04/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 N RAINBOW BLVD SUITE 215
LAS VEGAS NV
89107-1189
US

IV. Provider business mailing address

5550 LYNDON B JOHNSON FWY SUITE 360
DALLAS TX
75240
US

V. Phone/Fax

Practice location:
  • Phone: 702-888-0052
  • Fax: 702-952-1030
Mailing address:
  • Phone: 972-996-0900
  • Fax: 972-996-0905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0008X
TaxonomyNeuromuscular Medicine (Psychiatry & Neurology) Physician
License Number14570
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number14570
License Number StateNV

VIII. Authorized Official

Name: DR. ROBERT M SUTHERLAND
Title or Position: PRESIDENT
Credential: MD
Phone: 903-330-6997