Healthcare Provider Details

I. General information

NPI: 1700451853
Provider Name (Legal Business Name): DALLAS PAIN SPECIALISTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2021
Last Update Date: 05/21/2021
Certification Date: 05/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13052 DALLAS PKWY STE 220
FRISCO TX
75033-4241
US

IV. Provider business mailing address

4411 WYNNEWOOD DR
CEDAR FALLS IA
50613-4770
US

V. Phone/Fax

Practice location:
  • Phone: 214-808-7724
  • Fax:
Mailing address:
  • Phone: 214-808-7724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MAHESH MOHAN
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 214-808-7724