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NPI Code Detail

MEDICARE: DUNCANVILLE PAIN PARTNERS, LLC

MEDICARE: DUNCANVILLE PAIN PARTNERS, LLC
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
1261QP3300XPain Clinic/Center
2261QA1903XAmbulatory Surgical Clinic/Center

General Provider Information

NPI Number : 1750572988
Entity Type Code : Organization
Provider Name (Legal Business Name) : DUNCANVILLE PAIN PARTNERS, LLC
Provider Business Mailing Address
First Line : PO BOX 108822
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73101-8822
Country : US
Telephone Number : 972-479-1115
Fax Number : 972-346-8013
Provider Business Practice Location Address
First Line : 7988 W VIRGINIA DR STE 100
Second Line :
City : DALLAS
State : TX
Zip : 75237-3764
Country : US
Telephone Number : 972-479-1115
Fax Number : 972-346-8013
Authorized Official
Title or Position : VP OF OPERATIONS
Name : TED GROESBECK
Credential :
Telephone Number : 972-234-4740
Provider Enumeration Date : 08/05/2007
Last Update Date : 08/05/2008

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Directions to “DUNCANVILLE PAIN PARTNERS, LLC ” Practice Location

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