Healthcare Provider Details

I. General information

NPI: 1215683156
Provider Name (Legal Business Name): TRICITY PAIN ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2022
Last Update Date: 03/01/2022
Certification Date: 03/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5802 SARATOGA BLVD STE 330
CORPUS CHRISTI TX
78414-4252
US

IV. Provider business mailing address

PO BOX 642016
DALLAS TX
75264-2016
US

V. Phone/Fax

Practice location:
  • Phone: 210-268-0129
  • Fax: 210-314-4609
Mailing address:
  • Phone: 210-268-0129
  • Fax: 210-314-4609

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