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General NPI Number Information
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NPI Number | 1295283018
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Entity Type | Organization
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Legal Business Name | PAIN RELIEF CENTER OF OKLAHOMA
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Dates
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Enumeration Date | 09/21/2016
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Last Update Date | 10/13/2016
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Provider Practice Location Address
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Address Line | 304 BOULDER ST
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City | PAWNEE
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State | OK
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Zip | 74058-4028
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Country | US
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Telephone | 918-771-0437
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 334
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City | BIXBY
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State | OK
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Zip | 74008-0334
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Country | US
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Telephone | 918-771-0437
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. ALBERT F SANCHEZ
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Credential |
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Telephone | 479-263-2690
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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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 | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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