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General NPI Number Information
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NPI Number | 1124806146
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Entity Type | Organization
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Legal Business Name | EPIC PAIN MANAGEMENT PLLC
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Dates
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Enumeration Date | 09/20/2023
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 8522 BROADWAY STE 216
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City | SAN ANTONIO
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State | TX
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Zip | 78217-6456
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Country | US
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Telephone | 210-874-5260
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Fax |
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Provider Business Mailing Address
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Address Line | 202 ASHLING
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City | SAN ANTONIO
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State | TX
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Zip | 78260-3508
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Country | US
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Telephone | 305-342-6140
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | WANDA NORGARD
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Credential |
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Telephone | 512-665-3788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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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 | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #5
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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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