Healthcare Provider Details

I. General information

NPI: 1801435896
Provider Name (Legal Business Name): COMPREHENSIVE PAIN INSTITUTE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2019
Last Update Date: 01/06/2020
Certification Date: 01/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 AIRPORT FWY STE 302B
BEDFORD TX
76021-6604
US

IV. Provider business mailing address

1305 AIRPORT FWY STE 302B
BEDFORD TX
76021-6604
US

V. Phone/Fax

Practice location:
  • Phone: 817-786-8238
  • Fax:
Mailing address:
  • Phone: 817-786-8238
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ROMANA NAZIR
Title or Position: CREDENTIALING
Credential:
Phone: 817-666-0556