Provider Demographics
NPI:1154657179
Name:INTERVENTIONAL PAIN & AESTHETICS
Entity Type:Organization
Organization Name:INTERVENTIONAL PAIN & AESTHETICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:RAJAGIRIYIL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:214-455-9029
Mailing Address - Street 1:118 N JOBSON RD
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:TX
Mailing Address - Zip Code:75182-5001
Mailing Address - Country:US
Mailing Address - Phone:214-455-9029
Mailing Address - Fax:
Practice Address - Street 1:118 N JOBSON RD
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:TX
Practice Address - Zip Code:75182-5001
Practice Address - Country:US
Practice Address - Phone:214-455-9029
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-27
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207L00000X
TXN1089261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPainGroup - Multi-Specialty