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INTERVENTIONAL PAIN MANAGEMENT PA NPI 1114113669


NPI Information

NPI: 1114113669
Provider Name: INTERVENTIONAL PAIN MANAGEMENT, PA
Classification: Anesthesiology - 207LP2900X
Entity Type: Organization

Specialization: Pain Medicine

CLIA Number: 45D1083648

Address:
3312 N UNIVERSITY DR
SUITE J
NACOGDOCHES, TX
ZIP 75965
Phone: (936) 560-2222
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INTERVENTIONAL PAIN MANAGEMENT, PA is a pain medicine anesthesiology in Nacogdoches, TX. The provider is an anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. INTERVENTIONAL PAIN MANAGEMENT, PA NPI is 1114113669. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3312 N UNIVERSITY DR
SUITE J
NACOGDOCHES, TX
ZIP 75965-637
Phone: (936) 560-2222
Fax: (936) 569-1788

The provider's authorized official is James D Davis .
The authorized official title is Md/owner and has the following contact phone number (936) 560-2222.

The CLIA number assigned to this NPI record is 45D1083648 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/19/2007 and was last updated on 7/21/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207LP2900XAnesthesiologyPain MedicineJ8185TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1DF4810OTHERPALMETTO GBA
2184657801MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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