Provider Demographics
NPI:1346782430
Name:FTIC PAIN MANAGEMENT PLLC
Entity Type:Organization
Organization Name:FTIC PAIN MANAGEMENT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MOSHE
Authorized Official - Middle Name:
Authorized Official - Last Name:FELDHENDLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-500-5755
Mailing Address - Street 1:PO BOX 798045
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75379-8045
Mailing Address - Country:US
Mailing Address - Phone:214-415-6845
Mailing Address - Fax:
Practice Address - Street 1:5550 LBJ FWY
Practice Address - Street 2:SUITE 155
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6217
Practice Address - Country:US
Practice Address - Phone:214-415-6845
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM6129207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty