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General NPI Number Information
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NPI Number | 1013314632
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Entity Type | Organization
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Legal Business Name | OSTEOCARE PAIN CENTER, INC.
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Dates
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Enumeration Date | 11/25/2014
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Last Update Date | 11/25/2014
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Provider Practice Location Address
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Address Line | 2620 GUS THOMASSON RD. SUITE 102
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City | MESQUITE
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State | TX
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Zip | 75150
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Country | US
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Telephone | 972-850-0973
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Fax | 972-685-0147
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Provider Business Mailing Address
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Address Line | 2620 GUS THOMASSON RD. SUITE 102
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City | MESQUITE
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State | TX
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Zip | 75150
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Country | US
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Telephone | 972-850-0973
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Fax | 972-685-0147
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | PETER TRAN
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Credential |
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Telephone | 972-850-0973
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC12787
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License Number State | TX
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