MEDICARE: PAIN PARTNERS OF TEXAS PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	TX
2	208VP0000X	Pain Medicine Physician	TX
3	208VP0014X	Interventional Pain Medicine Physician	TX

General Provider Information

NPI Number	:	1356732903
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAIN PARTNERS OF TEXAS PLLC

Provider Business Mailing Address
First Line	:	1927 LOHMANS CROSSING RD
Second Line	:	TOWER 1, SUITE 202
City	:	LAKEWAY
State	:	TX
Zip	:	78734-5239
Country	:	US
Telephone Number	:	512-534-5039
Fax Number	:	512-857-0620

Provider Business Practice Location Address
First Line	:	1927 LOHMANS CROSSING RD
Second Line	:	TOWER 1, SUITE 202
City	:	LAKEWAY
State	:	TX
Zip	:	78734-5239
Country	:	US
Telephone Number	:	512-534-5039
Fax Number	:	512-857-0620

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CHRISTOPHER VIJE
Credential	:	MD
Telephone Number	:	512-534-5039

Provider Enumeration Date	:	02/17/2015
Last Update Date	:	02/17/2015

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Directions to “PAIN PARTNERS OF TEXAS PLLC ” Practice Location

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