Provider Demographics
NPI:1326610825
Name:CENTRAL LAREDO PAIN & RECOVERY
Entity Type:Organization
Organization Name:CENTRAL LAREDO PAIN & RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDEEP
Authorized Official - Middle Name:K
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:713-820-3708
Mailing Address - Street 1:8511 MCPHERSON RD STE 208
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-6617
Mailing Address - Country:US
Mailing Address - Phone:956-462-7353
Mailing Address - Fax:956-462-7409
Practice Address - Street 1:8511 MCPHERSON RD STE 208
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78045-6617
Practice Address - Country:US
Practice Address - Phone:956-462-7353
Practice Address - Fax:956-462-7409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6318OtherSTATE MEDICAL LICENSE