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NPI Code Detail

MEDICARE: PHYSICIAN PAIN CARE ASSOCIATES

MEDICARE: PHYSICIAN PAIN CARE ASSOCIATES
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
1208VP0000XPain Medicine Physician

General Provider Information

NPI Number : 1316312317
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHYSICIAN PAIN CARE ASSOCIATES
Provider Business Mailing Address
First Line : 319 S 1ST ST STE 16
Second Line :
City : TEMPLE
State : TX
Zip : 76504-5500
Country : US
Telephone Number : 254-300-8339
Fax Number : 844-214-2393
Provider Business Practice Location Address
First Line : 319 S 1ST ST STE 16
Second Line :
City : TEMPLE
State : TX
Zip : 76504-5500
Country : US
Telephone Number : 254-300-8339
Fax Number : 844-214-2393
Authorized Official
Title or Position : CREDENTIALING SPECIALIST
Name : CHRISTINE HAASS
Credential :
Telephone Number : 210-391-2653
Provider Enumeration Date : 12/02/2015
Last Update Date : 12/02/2015

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Directions to “PHYSICIAN PAIN CARE ASSOCIATES ” Practice Location

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