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General NPI Number Information
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NPI Number | 1003835133
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Entity Type | Organization
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Legal Business Name | PREMIER PAIN CONSULTANTS, PLLC
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 2425 BABCOCK RD STE 108
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City | SAN ANTONIO
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State | TX
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Zip | 78229-4899
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Country | US
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Telephone | 210-775-3455
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Fax | 210-775-3455
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Provider Business Mailing Address
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Address Line | 2425 BABCOCK RD STE 108
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City | SAN ANTONIO
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State | TX
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Zip | 78229-4899
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Country | US
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Telephone | 210-775-3455
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Fax | 210-775-3455
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Authorized Official
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Title or Position | PRESIDENT
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Name | DMITRIY BUYANOV
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Credential | M.D.
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Telephone | 210-775-3455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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