Provider Demographics
NPI:1093475832
Name:PAIN CONTROL OF TEXAS PLLC
Entity Type:Organization
Organization Name:PAIN CONTROL OF TEXAS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VIVEK
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHENDRU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-371-6398
Mailing Address - Street 1:2200 PARK BEND DR
Mailing Address - Street 2:BUILDING 1, SUITE 300
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-5386
Mailing Address - Country:US
Mailing Address - Phone:512-371-6398
Mailing Address - Fax:
Practice Address - Street 1:2200 PARK BEND DR STE 300
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5386
Practice Address - Country:US
Practice Address - Phone:512-371-6398
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-21
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXJ7566OtherTMB