NPI Code Details Logo

NPI 1003835133

NPI 1003835133 : PREMIER PAIN CONSULTANTS, PLLC : SAN ANTONIO, TX

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1003835133
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    PREMIER PAIN CONSULTANTS, PLLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    07/19/2006
-----------------------------------------------------
    Last Update Date     |    12/02/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    2425 BABCOCK RD STE 108 
-----------------------------------------------------
    City                 |    SAN ANTONIO
-----------------------------------------------------
    State                |    TX
-----------------------------------------------------
    Zip                  |    78229-4899
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    210-775-3455
-----------------------------------------------------
    Fax                  |    210-775-3455
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    2425 BABCOCK RD STE 108 
-----------------------------------------------------
    City                 |    SAN ANTONIO
-----------------------------------------------------
    State                |    TX
-----------------------------------------------------
    Zip                  |    78229-4899
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    210-775-3455
-----------------------------------------------------
    Fax                  |    210-775-3455
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    PRESIDENT
-----------------------------------------------------
    Name                 |     DMITRIY  BUYANOV 
-----------------------------------------------------
    Credential           |    M.D.
-----------------------------------------------------
    Telephone            |    210-775-3455
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    207LP2900X
-----------------------------------------------------
    Taxonomy Name        |    Pain Medicine (Anesthesiology) Physician
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    213ES0103X
-----------------------------------------------------
    Taxonomy Name        |    Foot & Ankle Surgery Podiatrist
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
    Taxonomy Code        |    208VP0014X
-----------------------------------------------------
    Taxonomy Name        |    Interventional Pain Medicine Physician
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.