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General NPI Number Information
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NPI Number | 1699468546
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Entity Type | Organization
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Legal Business Name | TEXAS SPINE & PAIN MD PLLC
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Dates
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Enumeration Date | 05/26/2023
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Last Update Date | 01/03/2024
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Provider Practice Location Address
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Address Line | 1055 CLARKSVILLE ST STE 165
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City | PARIS
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State | TX
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Zip | 75460-0211
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Country | US
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Telephone | 903-401-5145
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Fax | 903-401-5146
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Provider Business Mailing Address
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Address Line | PO BOX 429
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City | BONHAM
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State | TX
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Zip | 75418-0429
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Country | US
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Telephone | 903-401-5145
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Fax | 903-401-5146
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Authorized Official
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Title or Position | CEO
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Name | PRAVEEN NATAKAL PAKEERAPPA
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Credential | MD
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Telephone | 903-401-5145
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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