Provider Demographics
NPI:1407920358
Name:PAIN RELIEF MANAGEMENT PC
Entity Type:Organization
Organization Name:PAIN RELIEF MANAGEMENT PC
Other - Org Name:ADVANCED RELIEF CHIROPRACTIC AND ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDEE
Authorized Official - Middle Name:MARISA
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:940-484-8894
Mailing Address - Street 1:405 W OAK ST
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-9039
Mailing Address - Country:US
Mailing Address - Phone:940-484-8894
Mailing Address - Fax:940-484-1389
Practice Address - Street 1:405 W OAK ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-9039
Practice Address - Country:US
Practice Address - Phone:940-484-8894
Practice Address - Fax:940-484-1389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7880111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8857MOMedicare ID - Type Unspecified
TXU84535Medicare UPIN