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General NPI Number Information
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NPI Number | 1831908318
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Entity Type | Organization
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Legal Business Name | ADVANCE 911 PAIN MANAGEMENT
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Dates
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Enumeration Date | 12/30/2024
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 6900 N 10TH ST STE 4
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City | MCALLEN
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State | TX
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Zip | 78504-3151
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Country | US
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Telephone | 956-627-5137
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Fax |
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Provider Business Mailing Address
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Address Line | 5111 N 10TH ST # 137
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City | MCALLEN
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State | TX
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Zip | 78504-2835
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | CHRISTOPHER MCLEAN
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Credential |
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Telephone | 305-619-9874
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology 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 | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) 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 | 208VP0000X
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Taxonomy Name | Pain Medicine 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 | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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