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General NPI Number Information
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NPI Number | 1669860326
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Entity Type | Organization
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Legal Business Name | CITY PAIN MANAGEMENT PLLC
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Dates
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Enumeration Date | 01/05/2015
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Last Update Date | 03/03/2020
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Provider Practice Location Address
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Address Line | 1501 KINGS HWY DEPT OF
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City | SHREVEPORT
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State | LA
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Zip | 71103-4228
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Country | US
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Telephone | 318-626-4041
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Fax |
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Provider Business Mailing Address
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Address Line | 3628 AMHERST AVE
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City | DALLAS
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State | TX
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Zip | 75225-7421
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Country | US
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Telephone | 214-308-1580
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RINOO VASANT SHAH
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Credential |
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Telephone | 214-308-1580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | L4708
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License Number State | TX
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