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General NPI Number Information
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NPI Number | 1982806204
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Entity Type | Organization
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Legal Business Name | SUMMIT SPECIALISTS OF PAIN, PLLC
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Dates
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Enumeration Date | 05/31/2007
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Last Update Date | 09/03/2024
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Provider Practice Location Address
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Address Line | 4000 WESLEY ST STE D
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City | GREENVILLE
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State | TX
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Zip | 75401-9015
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Country | US
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Telephone | 945-766-4467
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Fax | 972-777-9939
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Provider Business Mailing Address
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Address Line | 2931 RIDGE RD STE 101-159
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City | ROCKWALL
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State | TX
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Zip | 75032-6670
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Country | US
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Telephone | 972-741-5953
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Fax | 972-777-9939
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Authorized Official
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Title or Position | MD/CEO
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Name | STANLEY W WHISENANT
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Credential | MD
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Telephone | 945-766-4467
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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 | J7725
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License Number State | TX
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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 | J7725
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License Number State | TX
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