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General NPI Number Information
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NPI Number | 1639696016
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Entity Type | Organization
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Legal Business Name | HEALTH AND PAIN MEDICINE INSTITUTE, P.A.
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Dates
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Enumeration Date | 08/25/2017
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Last Update Date | 08/25/2017
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Provider Practice Location Address
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Address Line | 1700 PACIFIC AVE STE 260
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City | DALLAS
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State | TX
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Zip | 75201-7478
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Country | US
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Telephone | 503-489-7652
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Fax | 877-778-5117
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Provider Business Mailing Address
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Address Line | 3900 TELEPORT BLVD UNIT 143361
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City | IRVING
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State | TX
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Zip | 75014-0239
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Country | US
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Telephone | 503-489-7652
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | OLUWASOLA OLAMIKAN
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Credential | MD
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Telephone | 503-489-7652
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP3000X
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Taxonomy Name | Pediatric Anesthesiology Physician
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License Number | P1378
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License Number State | TX
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