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General NPI Number Information
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NPI Number | 1528259322
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Entity Type | Organization
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Legal Business Name | MD PAIN CLINIC, INC.
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Dates
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Enumeration Date | 08/06/2007
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Last Update Date | 08/06/2007
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Provider Practice Location Address
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Address Line | 2406 W SEMINARY DR
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City | FORT WORTH
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State | TX
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Zip | 76115-1917
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Country | US
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Telephone | 817-261-0704
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Fax |
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Provider Business Mailing Address
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Address Line | 2004 BOTTS DR
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City | ARLINGTON
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State | TX
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Zip | 76012-1817
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES DAVID ALEXANDER
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Credential | DC
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Telephone | 817-228-1522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | DC5030
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License Number State | TX
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