MEDICARE: AMERICAN PAIN & WELLNESS PA

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	208100000X	Physical Medicine & Rehabilitation Physician
2	208VP0014X	Interventional Pain Medicine Physician
3	291U00000X	Clinical Medical Laboratory
4	207LP2900X	Pain Medicine (Anesthesiology) Physician

General Provider Information

NPI Number	:	1306857305
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN PAIN & WELLNESS PA

Provider Business Mailing Address
First Line	:	3308 PRESTON RD STE 350-105
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-7453
Country	:	US
Telephone Number	:	469-326-5100
Fax Number	:	469-326-5101

Provider Business Practice Location Address
First Line	:	1101 RAINTREE CIR STE 240
Second Line	:
City	:	ALLEN
State	:	TX
Zip	:	75013-4926
Country	:	US
Telephone Number	:	469-326-5100
Fax Number	:

Authorized Official
Title or Position	:	CHIEF OPERATIONS OFFICER
Name	:	SHIRLEY KRETZ
Credential	:
Telephone Number	:	469-326-5151

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	06/06/2023

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Directions to “AMERICAN PAIN & WELLNESS PA ” Practice Location

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