Provider Demographics
NPI:1013360999
Name:AXIS PAIN INSTITUTE OF NORTH AMERICA
Entity Type:Organization
Organization Name:AXIS PAIN INSTITUTE OF NORTH AMERICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:SAEID
Authorized Official - Middle Name:
Authorized Official - Last Name:ARYAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:817-502-7411
Mailing Address - Street 1:PO BOX 77202
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76177-0202
Mailing Address - Country:US
Mailing Address - Phone:817-502-7411
Mailing Address - Fax:
Practice Address - Street 1:1209 SAINT EMILION CT
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-4617
Practice Address - Country:US
Practice Address - Phone:817-502-7411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-15
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies