Provider Demographics
NPI:1427554880
Name:PAIN INSTITUTE OF LAREDO
Entity Type:Organization
Organization Name:PAIN INSTITUTE OF LAREDO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOCHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-568-1846
Mailing Address - Street 1:5401 MCPHERSON RD STE 9
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6834
Mailing Address - Country:US
Mailing Address - Phone:956-704-5157
Mailing Address - Fax:956-704-5162
Practice Address - Street 1:5401 MCPHERSON RD STE 9
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041
Practice Address - Country:US
Practice Address - Phone:956-704-5157
Practice Address - Fax:956-704-5162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-04
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
208VP0014X
TX261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPainGroup - Single Specialty