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General NPI Number Information
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NPI Number | 1720441538
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Entity Type | Organization
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Legal Business Name | OMNI SPINE PAIN MANAGEMENT, PLLC
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Dates
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Enumeration Date | 03/30/2016
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Last Update Date | 07/22/2021
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Provider Practice Location Address
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Address Line | 6243 RETAIL RD STE 500
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City | DALLAS
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State | TX
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Zip | 75231-7867
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Country | US
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Telephone | 214-705-1200
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Fax | 214-705-1201
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Provider Business Mailing Address
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Address Line | 8380 WARREN PKWY STE 100
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City | FRISCO
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State | TX
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Zip | 75034-4199
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Country | US
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Telephone | 214-705-1200
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Fax | 214-705-1201
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Authorized Official
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Title or Position | BILLING DEPARTMENT
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Name | MS. WHITNEY RAE HUGHES
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Credential |
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Telephone | 972-645-1260
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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 | N1784
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License Number State | TX
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