MEDICARE: ELM PAIN INSTITUTE

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	208VP0000X	Pain Medicine Physician

General Provider Information

NPI Number	:	1659088367
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELM PAIN INSTITUTE

Provider Business Mailing Address
First Line	:	8616 GREENVILLE AVE STE 101
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75243-7166
Country	:	US
Telephone Number	:	214-450-9926
Fax Number	:

Provider Business Practice Location Address
First Line	:	8616 GREENVILLE AVE STE 101
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75243-7166
Country	:	US
Telephone Number	:	214-450-9926
Fax Number	:

Authorized Official
Title or Position	:	BILLING MANANGER
Name	:	THOMAS JEFFERSON
Credential	:
Telephone Number	:	214-977-6357

Provider Enumeration Date	:	11/02/2022
Last Update Date	:	05/12/2025

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Directions to “ELM PAIN INSTITUTE ” Practice Location

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