Provider Demographics
NPI:1235334830
Name:SOUTH TEXAS CLINIC FOR PAIN MANAGEMENT
Entity Type:Organization
Organization Name:SOUTH TEXAS CLINIC FOR PAIN MANAGEMENT
Other - Org Name:SOUTH TEXAS CLINIC FOR PAIN MANAGEMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAHID
Authorized Official - Middle Name:
Authorized Official - Last Name:RASHID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-687-8120
Mailing Address - Street 1:801 E NOLANA ST
Mailing Address - Street 2:STE. 7
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-6104
Mailing Address - Country:US
Mailing Address - Phone:956-687-8120
Mailing Address - Fax:956-686-9464
Practice Address - Street 1:5505 S EXPRESSWAY 77
Practice Address - Street 2:STE. 106
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-3214
Practice Address - Country:US
Practice Address - Phone:956-423-9996
Practice Address - Fax:956-365-3410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8R0190OtherBLUECROSS BLUESHIELD
TX050059OtherTRICARE
TX050059OtherTRICARE
TX00015XMedicare ID - Type UnspecifiedGROUP NUMBER