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General NPI Number Information
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NPI Number | 1891663761
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Entity Type | Organization
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Legal Business Name | TRISTATE PAIN SURGERY CENTER, LLC
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Dates
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Enumeration Date | 10/23/2025
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Last Update Date | 01/27/2026
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Provider Practice Location Address
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Address Line | 6426 HIGHWAY 51 N STE A
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City | HORN LAKE
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State | MS
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Zip | 38637-2474
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Country | US
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Telephone | 662-929-0200
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Fax | 662-929-0300
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Provider Business Mailing Address
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Address Line | 6426 HIGHWAY 51 N STE A
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City | HORN LAKE
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State | MS
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Zip | 38637-2474
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Country | US
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Telephone | 662-929-0200
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Fax | 662-929-0300
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Authorized Official
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Title or Position | PRESIDENT
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Name | MAHENDRA SANAPATI
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Credential | MF
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Telephone | 812-573-1207
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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