Provider Demographics
NPI:1538303441
Name:CARDINAL PAIN CENTER PA
Entity Type:Organization
Organization Name:CARDINAL PAIN CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:VIJAYASREE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARVIND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-226-3988
Mailing Address - Street 1:221 W. COLORADO BLVD
Mailing Address - Street 2:PAVILLION 2 SUITE 940
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-1259
Mailing Address - Country:US
Mailing Address - Phone:214-377-1753
Mailing Address - Fax:214-946-1988
Practice Address - Street 1:221 W. COLORADO BLVD
Practice Address - Street 2:PAVILLION 2 SUITE 940
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-1259
Practice Address - Country:US
Practice Address - Phone:214-377-1753
Practice Address - Fax:214-946-1988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-22
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6485450001Medicare NSC