Provider Demographics
NPI:1063831626
Name:PAIN STOP CLINIC, LLC
Entity Type:Organization
Organization Name:PAIN STOP CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ZUBAIR
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHAUDARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-477-2876
Mailing Address - Street 1:708 W MCNEESE ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-5532
Mailing Address - Country:US
Mailing Address - Phone:337-477-2876
Mailing Address - Fax:
Practice Address - Street 1:708 W MCNEESE ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-5532
Practice Address - Country:US
Practice Address - Phone:337-477-2876
Practice Address - Fax:337-478-5872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-10
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty