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General NPI Number Information
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NPI Number | 1699988691
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Entity Type | Organization
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Legal Business Name | RENAISSANCE PAIN MANAGEMENT, LTD
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 04/15/2016
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Provider Practice Location Address
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Address Line | 4228 N MCCOLL RD
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City | MCALLEN
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State | TX
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Zip | 78504-2523
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Country | US
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Telephone | 956-682-4151
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Fax | 956-682-4154
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Provider Business Mailing Address
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Address Line | PO BOX 3328
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City | MCALLEN
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State | TX
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Zip | 78502-3328
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Country | US
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Telephone | 956-682-4151
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Fax | 956-682-4154
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Authorized Official
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Title or Position | OWNER
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Name | RAYMOND WALKER
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Credential |
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Telephone | 956-682-4151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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