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General NPI Number Information
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NPI Number | 1578184685
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Entity Type | Organization
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Legal Business Name | PAIN MANAGEMENT PHYSICIANS OF DALLAS PLLC
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Dates
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Enumeration Date | 04/29/2020
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 8404 STERLING ST STE B
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City | IRVING
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State | TX
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Zip | 75063-2527
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Country | US
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Telephone | 214-948-7700
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Fax | 214-948-7701
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Provider Business Mailing Address
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Address Line | 1411 N BECKLEY AVE STE 152
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City | DALLAS
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State | TX
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Zip | 75203-1586
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Country | US
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Telephone | 214-948-7700
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Fax | 214-948-7701
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | KERRY SHEEHAN
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Credential |
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Telephone | 214-948-7700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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