Provider Demographics
NPI:1275185266
Name:CORPUS CHOICE PAIN MANAGEMENT
Entity Type:Organization
Organization Name:CORPUS CHOICE PAIN MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DEVIN
Authorized Official - Last Name:PARRISH
Authorized Official - Suffix:
Authorized Official - Credentials:FNP, DC
Authorized Official - Phone:361-504-4300
Mailing Address - Street 1:3425 TWIN RIVER BLVD
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78410-2000
Mailing Address - Country:US
Mailing Address - Phone:361-504-4300
Mailing Address - Fax:
Practice Address - Street 1:3425 TWIN RIVER BLVD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78410-2000
Practice Address - Country:US
Practice Address - Phone:361-504-4300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-10
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty