Provider Demographics
NPI:1518317965
Name:TYSON'S PAIN CENTER, P.C.
Entity Type:Organization
Organization Name:TYSON'S PAIN CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:HASSAN
Authorized Official - Last Name:NAGIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-897-1300
Mailing Address - Street 1:8133 LEESBURG PIKE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:VIENNA,
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2706
Mailing Address - Country:US
Mailing Address - Phone:703-897-1300
Mailing Address - Fax:703-897-1301
Practice Address - Street 1:8133 LEESBURG PIKE
Practice Address - Street 2:SUITE 305
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-2751
Practice Address - Country:US
Practice Address - Phone:703-897-1300
Practice Address - Fax:703-897-1301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-16
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101057229261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain