Provider Demographics
NPI:1558839795
Name:PREMIER PAIN CONSULTANTS, PLLC
Entity Type:Organization
Organization Name:PREMIER PAIN CONSULTANTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BATTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-616-9400
Mailing Address - Street 1:5522 LONE STAR PKWY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-6719
Mailing Address - Country:US
Mailing Address - Phone:210-616-9400
Mailing Address - Fax:
Practice Address - Street 1:5522 LONE STAR PKWY
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78253-6719
Practice Address - Country:US
Practice Address - Phone:210-616-9400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PREMIER PAIN CONSULTANTS, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-11-06
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX21146002Medicaid