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General NPI Number Information
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NPI Number | 1891064168
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Entity Type | Organization
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Legal Business Name | NTX PAIN AND REHAB, PLLC
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Dates
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Enumeration Date | 12/15/2011
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Last Update Date | 12/15/2011
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Provider Practice Location Address
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Address Line | 4549 FIREWHEEL DR
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City | PLANO
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State | TX
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Zip | 75024-3970
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Country | US
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Telephone | 856-577-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 8000 COIT RD SUITE 300-342
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City | PLANO
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State | TX
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Zip | 75025-6819
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Country | US
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Telephone | 856-577-5437
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MANU GUPTA
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Credential | MD
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Telephone | 856-577-5437
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | N4446
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License Number State | TX
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