Provider Demographics
NPI:1073897716
Name:COMPREHENSIVE PAIN CONSULTANTS OF THE CAROLINAS, PLLC
Entity Type:Organization
Organization Name:COMPREHENSIVE PAIN CONSULTANTS OF THE CAROLINAS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-927-7607
Mailing Address - Street 1:PO BOX 254
Mailing Address - Street 2:
Mailing Address - City:SKYLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28776
Mailing Address - Country:US
Mailing Address - Phone:828-708-9876
Mailing Address - Fax:828-687-7858
Practice Address - Street 1:26 GLEN COVE DR
Practice Address - Street 2:
Practice Address - City:ARDEN
Practice Address - State:NC
Practice Address - Zip Code:28704-3219
Practice Address - Country:US
Practice Address - Phone:941-753-5918
Practice Address - Fax:941-753-5964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-29
Last Update Date:2017-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200300171207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty