Healthcare Provider Details

I. General information

NPI: 1023763752
Provider Name (Legal Business Name): TRICITY PAIN ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2022
Last Update Date: 02/22/2022
Certification Date: 02/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1246 N FM 3083 RD W STE D
CONROE TX
77304-5340
US

IV. Provider business mailing address

19141 STONE OAK PKWY STE 104
SAN ANTONIO TX
78258-3367
US

V. Phone/Fax

Practice location:
  • Phone: 936-220-0090
  • Fax: 210-314-4609
Mailing address:
  • Phone: 210-756-5989
  • Fax: 210-314-4609

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: DR. URFAN AHMAD DAR
Title or Position: CEO
Credential: MD
Phone: 210-268-0158