Healthcare Provider Details

I. General information

NPI: 1225575582
Provider Name (Legal Business Name): STRATEGY PAIN CONSULTANTS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2017
Last Update Date: 02/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 OAK CENTRE DR SUITE 140
SAN ANTONIO TX
78258-3916
US

IV. Provider business mailing address

3943 IRVINE BLVD SUITE 628
IRVINE CA
92602-2400
US

V. Phone/Fax

Practice location:
  • Phone: 210-546-1410
  • Fax: 888-785-7669
Mailing address:
  • Phone: 323-999-4963
  • Fax: 888-785-7669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberJ1013
License Number StateTX

VIII. Authorized Official

Name: ELIEL NTAKIRUTIMANA
Title or Position: SOLE MEMBER
Credential: M.D.
Phone: 956-712-8147