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NPI Code Detail

MEDICARE: RGV INSTITUTE OF PAIN MANAGEMENT LLC

MEDICARE: RGV INSTITUTE OF PAIN MANAGEMENT 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
1207LP2900XPain Medicine (Anesthesiology) Physician

General Provider Information

NPI Number : 1265155931
Entity Type Code : Organization
Provider Name (Legal Business Name) : RGV INSTITUTE OF PAIN MANAGEMENT LLC
Provider Business Mailing Address
First Line : 1506 LONE STAR WAY STE 1
Second Line :
City : EDINBURG
State : TX
Zip : 78539
Country : US
Telephone Number : 361-944-7194
Fax Number :
Provider Business Practice Location Address
First Line : 1506 S LONE STAR WAY STE 1
Second Line :
City : EDINBURG
State : TX
Zip : 78539-4977
Country : US
Telephone Number : 956-731-0409
Fax Number : 956-322-4092
Authorized Official
Title or Position : PRESIDENT
Name : ANDRES MAURICIO PEREZ
Credential : MD
Telephone Number : 361-944-7194
Provider Enumeration Date : 09/19/2022
Last Update Date : 03/27/2023

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Directions to “RGV INSTITUTE OF PAIN MANAGEMENT LLC ” Practice Location

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