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General NPI Number Information
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NPI Number | 1306002282
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Entity Type | Organization
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Legal Business Name | METROPLEX INTERVENTIONAL PAIN CARE
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Dates
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Enumeration Date | 07/31/2008
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Last Update Date | 07/31/2008
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Provider Practice Location Address
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Address Line | 651 S MAIN ST STE 105
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City | KELLER
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State | TX
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Zip | 76248-7037
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Country | US
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Telephone | 817-741-0800
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Fax | 817-741-0805
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Provider Business Mailing Address
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Address Line | 914 LIPSCOMB ST
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City | FORT WORTH
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State | TX
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Zip | 76104-3169
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Country | US
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Telephone | 817-348-8600
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | VED V AGGARWAL
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Credential | MD
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Telephone | 817-348-8600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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