Healthcare Provider Details

I. General information

NPI: 1962454595
Provider Name (Legal Business Name): CLINIC FOR PAIN MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 08/31/2023
Certification Date: 08/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6750 N MACARTHUR BLVD STE 205
IRVING TX
75039-2470
US

IV. Provider business mailing address

700 HIGHLANDER BLVD STE 415
ARLINGTON TX
76015-4346
US

V. Phone/Fax

Practice location:
  • Phone: 214-637-0887
  • Fax: 817-516-8444
Mailing address:
  • Phone: 817-516-8811
  • Fax: 817-516-8444

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: MANUEL R. RAMIREZ
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 214-637-0887