Provider Demographics
NPI:1003246299
Name:TEXAS PAIN RELIEF GROUP PLLC
Entity Type:Organization
Organization Name:TEXAS PAIN RELIEF GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:RODOLFO
Authorized Official - Middle Name:
Authorized Official - Last Name:GARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-549-2134
Mailing Address - Street 1:4730 N HABANA AVE
Mailing Address - Street 2:204
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-7163
Mailing Address - Country:US
Mailing Address - Phone:813-549-2134
Mailing Address - Fax:813-549-2134
Practice Address - Street 1:1717 PRECINCT LINE RD
Practice Address - Street 2:200
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-3169
Practice Address - Country:US
Practice Address - Phone:855-549-7246
Practice Address - Fax:817-514-1901
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHYSICIAN PARTNERS OF AMERICA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-11-25
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain