Provider Demographics
NPI:1538326871
Name:INTERVENTIONAL PAIN ASSOCIATES
Entity Type:Organization
Organization Name:INTERVENTIONAL PAIN ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SAROSH
Authorized Official - Middle Name:
Authorized Official - Last Name:SALEEMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-516-1731
Mailing Address - Street 1:11111 RESEARCH BLVD
Mailing Address - Street 2:SUITE 370
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-5264
Mailing Address - Country:US
Mailing Address - Phone:512-795-7575
Mailing Address - Fax:877-782-8531
Practice Address - Street 1:11111 RESEARCH BLVD
Practice Address - Street 2:SUITE 370
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-5264
Practice Address - Country:US
Practice Address - Phone:512-795-7575
Practice Address - Fax:877-782-8531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4689207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX613913Medicare PIN
TXB144846Medicare PIN