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General NPI Number Information
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NPI Number | 1851565717
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Entity Type | Organization
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Legal Business Name | PAIN MANAGEMENT CENTER OF DALLAS
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Dates
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Enumeration Date | 04/22/2008
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Last Update Date | 06/02/2008
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Provider Practice Location Address
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Address Line | 712 N WASHINGTON AVE STE 404
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City | DALLAS
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State | TX
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Zip | 75246-1619
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Country | US
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Telephone | 214-370-4000
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Fax | 214-370-4008
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Provider Business Mailing Address
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Address Line | 712 N WASHINGTON AVE STE 404
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City | DALLAS
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State | TX
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Zip | 75246-1619
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Country | US
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Telephone | 214-370-4000
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Fax | 214-370-4008
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | VICTOR J RAMON
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Credential | M.D.
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Telephone | 214-370-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G1167
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License Number State | TX
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