Healthcare Provider Details

I. General information

NPI: 1881229565
Provider Name (Legal Business Name): TRICITY PAIN ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2020
Last Update Date: 07/30/2024
Certification Date: 07/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18707 HARDY OAK BLVD STE 500
SAN ANTONIO TX
78258-4841
US

IV. Provider business mailing address

PO BOX 642016
DALLAS TX
75264-2016
US

V. Phone/Fax

Practice location:
  • Phone: 844-789-7246
  • Fax: 888-880-9323
Mailing address:
  • Phone: 210-756-5989
  • Fax: 210-568-4064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: LAURA JEAN PAREDEZ
Title or Position: DIRECTOR REVENUE CYCLE MANAGEMENT
Credential:
Phone: 210-268-0129