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General NPI Number Information
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NPI Number | 1760598577
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Entity Type | Organization
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Legal Business Name | ACUTE AND CHRONIC PAIN MANAGEMENT CENTER PA
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 24 CARE CIR
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City | AMARILLO
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State | TX
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Zip | 79124-2118
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Country | US
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Telephone | 806-353-6100
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Fax | 806-353-3372
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Provider Business Mailing Address
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Address Line | 24 CARE CIR
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City | AMARILLO
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State | TX
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Zip | 79124-2118
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Country | US
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Telephone | 806-353-6100
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Fax | 806-353-3372
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | SHAYDA CRADDICK
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Credential |
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Telephone | 806-353-6100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 204R00000X
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Taxonomy Name | Electrodiagnostic Medicine Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 2085R0203X
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Taxonomy Name | Therapeutic Radiology Physician
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 007835
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License Number State | TX
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