MEDICARE: TEXAS PAIN REHABILITATION INSTITUTE, PA

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	207LP2900X	Pain Medicine (Anesthesiology) Physician		TX

General Provider Information

NPI Number	:	1598763245
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEXAS PAIN REHABILITATION INSTITUTE, PA

Provider Business Mailing Address
First Line	:	7200 WYOMING SPGS STE 400
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-4304
Country	:	US
Telephone Number	:	512-310-7246
Fax Number	:	512-310-7667

Provider Business Practice Location Address
First Line	:	7200 WYOMING SPGS
Second Line	:	STE 400
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-4304
Country	:	US
Telephone Number	:	512-310-7246
Fax Number	:	512-310-7667

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	DR. GRAVES T OWEN
Credential	:	MD
Telephone Number	:	512-310-7246

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	07/21/2022

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Directions to “TEXAS PAIN REHABILITATION INSTITUTE, PA ” Practice Location

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