Provider Demographics
NPI:1326672296
Name:TRICITY PAIN ASSOCIATES PA
Entity Type:Organization
Organization Name:TRICITY PAIN ASSOCIATES PA
Other - Org Name:PHASE 4 PHYSIOTHERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:URFAN
Authorized Official - Middle Name:AHMAD
Authorized Official - Last Name:DAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-268-0129
Mailing Address - Street 1:19141 STONE OAK PKWY STE 104
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3367
Mailing Address - Country:US
Mailing Address - Phone:210-268-0129
Mailing Address - Fax:210-314-4609
Practice Address - Street 1:28255 INTERSTATE 10 W STE 103
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-6508
Practice Address - Country:US
Practice Address - Phone:830-755-5223
Practice Address - Fax:833-841-7131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-28
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty