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General NPI Number Information
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NPI Number | 1588956833
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Entity Type | Organization
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Legal Business Name | ATLANTIC TOTAL PAIN SOLUTION INC
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Dates
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Enumeration Date | 05/04/2011
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Last Update Date | 04/09/2012
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Provider Practice Location Address
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Address Line | 5501 S EXPRESSWAY 77
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City | HARLINGEN
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State | TX
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Zip | 78550-3213
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Country | US
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Telephone | 956-365-1167
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Fax |
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Provider Business Mailing Address
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Address Line | 1327 E WASHINGTON AVE STE 110
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City | HARLINGEN
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State | TX
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Zip | 78550-5684
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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 & CEO
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Name | ROBERT W MCINTOSH
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Credential | DO
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Telephone | 956-245-9739
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | M8177
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License Number State | TX
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