MEDICARE: TEXAS P&A LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician
2	111NR0400X	Rehabilitation Chiropractor

General Provider Information

NPI Number	:	1093314700
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEXAS P&A LLC

Provider Business Mailing Address
First Line	:	2500 PARKHURST CT
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-3209
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 S ZANG BLVD STE 1210
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75208-6624
Country	:	US
Telephone Number	:	972-467-1011
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	ARASH PAYROVAN
Credential	:	DC
Telephone Number	:	972-467-1011

Provider Enumeration Date	:	10/23/2020
Last Update Date	:	10/23/2020

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Directions to “TEXAS P&A LLC ” Practice Location

Language	Start Address	Practice Location

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