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General NPI Number Information
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NPI Number | 1386786564
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Entity Type | Organization
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Legal Business Name | SOUTHWESTERN PAIN INSTITUTE, PA
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 05/19/2009
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Provider Practice Location Address
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Address Line | 5744 LYNDON B JOHNSON FWY SUITE 175
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City | DALLAS
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State | TX
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Zip | 75240-6322
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Country | US
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Telephone | 972-980-4400
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Fax | 972-980-4100
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Provider Business Mailing Address
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Address Line | PO BOX 803311
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City | DALLAS
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State | TX
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Zip | 75380-3311
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Country | US
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Telephone | 972-980-4400
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Fax | 972-980-4100
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Authorized Official
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Title or Position | PAIN MANAGEMENT
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Name | DR. DANIEL SHALEV
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Credential | M.D.
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Telephone | 972-980-4400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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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 | 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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