Provider Demographics
NPI:1518501030
Name:INSTITUTE OF PRECISION PAIN MEDICINE, PLLC
Entity Type:Organization
Organization Name:INSTITUTE OF PRECISION PAIN MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JIGNA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-387-0046
Mailing Address - Street 1:13725 NORTHWEST BLVD STE 120A
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78410-3743
Mailing Address - Country:US
Mailing Address - Phone:361-387-0046
Mailing Address - Fax:
Practice Address - Street 1:13725 NORTHWEST BLVD STE 120A
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78410-3743
Practice Address - Country:US
Practice Address - Phone:361-387-0046
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-29
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty