MEDICARE: KNOLL TRAIL PAIN PROCEDURE CENTER

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	261QP3300X	Pain Clinic/Center

General Provider Information

NPI Number	:	1467779314
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KNOLL TRAIL PAIN PROCEDURE CENTER

Provider Business Mailing Address
First Line	:	PO BOX 269092
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73126-9092
Country	:	US
Telephone Number	:	469-916-0521
Fax Number	:	972-234-0212

Provider Business Practice Location Address
First Line	:	17051 DALLAS PKWY
Second Line	:	STE 100
City	:	ADDISON
State	:	TX
Zip	:	75001-7101
Country	:	US
Telephone Number	:	469-916-0521
Fax Number	:	972-234-0212

Authorized Official
Title or Position	:	MANAGER
Name	:	TRACY WALLS
Credential	:
Telephone Number	:	972-234-4740

Provider Enumeration Date	:	04/30/2010
Last Update Date	:	10/02/2013

Similar Medicare Providers

1730146473 — DR. ROBERT GERARD VIERE M.D
Practice Location Address:

17051 DALLAS PKWY STE 400 , SUITE 400
ADDISON, TX
75001-7101

Practice Phone: 214-370-3535
Practice Fax: 214-370-0004

1083664528 — DR. CHUN M LIN M.D.
Practice Location Address:

17051 DALLAS PKWY STE 400 , SUITE 400
ADDISON, TX
75001-7101

Practice Phone: 214-370-3535
Practice Fax: 214-370-0004

1871748384 — TEXAS SPINE CONSULTANTS, LLP
Practice Location Address:

17051 DALLAS PKWY , SUITE 400
ADDISON, TX
75001-7101

Practice Phone: 214-370-3535
Practice Fax: 214-370-0004

1992027312 — WEST PLANO INTERVENTIONAL SPINE AND PROCEDURE CENTER LLC
Practice Location Address:

17051 DALLAS PKWY , SUITE 100
ADDISON, TX
75001-7101

Practice Phone: 469-916-0521
Practice Fax: 972-234-0212

1093038507 — WILLOWBEND INTERVENTIONAL PAIN CENTER, LLC
Practice Location Address:

17051 DALLAS PKWY , STE 100
ADDISON, TX
75001-7101

Practice Phone: 469-916-0521
Practice Fax: 972-234-0212

1427375047 — PARKER ROAD INTERVENTIONAL PAIN PROCEDURE CENTER, LLC
Practice Location Address:

17051 DALLAS PKWY , SUITE 100
ADDISON, TX
75001-7101

Practice Phone: 469-916-0521
Practice Fax: 972-234-0212

Directions to “KNOLL TRAIL PAIN PROCEDURE CENTER ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.