Provider Demographics
NPI:1306002282
Name:METROPLEX INTERVENTIONAL PAIN CARE
Entity Type:Organization
Organization Name:METROPLEX INTERVENTIONAL PAIN CARE
Other - Org Name:TEXAS PAIN INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VED
Authorized Official - Middle Name:V
Authorized Official - Last Name:AGGARWAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-348-8600
Mailing Address - Street 1:914 LIPSCOMB ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-3169
Mailing Address - Country:US
Mailing Address - Phone:817-348-8600
Mailing Address - Fax:
Practice Address - Street 1:651 S MAIN ST
Practice Address - Street 2:STE 105
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-7037
Practice Address - Country:US
Practice Address - Phone:817-741-0800
Practice Address - Fax:817-741-0805
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:METROPLEX INTERVENTIONAL PAIN CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain