Provider Demographics
NPI:1225371826
Name:NEUROPATHY RELIEF CENTERS INC
Entity Type:Organization
Organization Name:NEUROPATHY RELIEF CENTERS INC
Other - Org Name:TRIANGLE HEALTH CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BODRE
Authorized Official - Middle Name:
Authorized Official - Last Name:RISING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:409-289-1411
Mailing Address - Street 1:5755 COLLEGE STREET
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77707
Mailing Address - Country:US
Mailing Address - Phone:409-840-9300
Mailing Address - Fax:409-842-4960
Practice Address - Street 1:2503 S AVENUE A
Practice Address - Street 2:SUITE NO1
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-7173
Practice Address - Country:US
Practice Address - Phone:928-783-3656
Practice Address - Fax:928-329-4495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-02
Last Update Date:2013-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ158419Medicare PIN