Provider Demographics
NPI:1083340517
Name:THE NEXUS PAIN CENTER OF HOUSTON COUNTY LLC
Entity Type:Organization
Organization Name:THE NEXUS PAIN CENTER OF HOUSTON COUNTY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:CHANDRESH
Authorized Official - Middle Name:VITHAL
Authorized Official - Last Name:VIRADIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:478-971-4001
Mailing Address - Street 1:100 JIM MASON CT STE A
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-8965
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:230 SHERATON BLVD STE A
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-1358
Practice Address - Country:US
Practice Address - Phone:478-474-2947
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE NEXUS PAIN CENTER OF HOUSTON COUNTY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty