Healthcare Provider Details

I. General information

NPI: 1457401135
Provider Name (Legal Business Name): ACCIDENT & INJURY PAIN CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1504 PENNSYLVANIA AVE
FT WORTH TX
76104-2027
US

IV. Provider business mailing address

200 WYNNEWOOD VILLAGE
DALLAS TX
75224
US

V. Phone/Fax

Practice location:
  • Phone: 817-335-4878
  • Fax: 817-335-4890
Mailing address:
  • Phone: 214-378-4499
  • Fax: 214-948-6576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. THOMAS RHUDY
Title or Position: CHIEF OF STAFF
Credential: DC
Phone: 214-378-4499