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General NPI Number Information
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NPI Number | 1861494080
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Entity Type | Organization
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Legal Business Name | ABILENE AMBULATORY SURGERY CENTER FOR PAIN MANAGEMENT, LLC
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Dates
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Enumeration Date | 06/01/2005
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Last Update Date | 09/17/2008
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Provider Practice Location Address
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Address Line | 6399 DIRECTORS PKWY SUITE 100
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City | ABILENE
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State | TX
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Zip | 79606-5873
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Country | US
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Telephone | 325-794-5450
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Fax | 325-794-5498
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Provider Business Mailing Address
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Address Line | 6399 DIRECTORS PKWY SUITE 100
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City | ABILENE
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State | TX
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Zip | 79606-5873
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Country | US
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Telephone | 325-794-5450
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Fax | 325-794-5498
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DR. GARY HEATH
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Credential | M.D.
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Telephone | 325-794-5450
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number | 007313
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License Number State | TX
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