Provider Demographics
NPI:1568512515
Name:J SUBRAMANIAN MD PLLC
Entity Type:Organization
Organization Name:J SUBRAMANIAN MD PLLC
Other - Org Name:MD PAIN PRACTICE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOYSREE
Authorized Official - Middle Name:
Authorized Official - Last Name:SUBRAMANIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-939-7246
Mailing Address - Street 1:4325 N JOSEY LN
Mailing Address - Street 2:PLAZA III STE.206
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-4635
Mailing Address - Country:US
Mailing Address - Phone:972-939-7246
Mailing Address - Fax:972-394-0293
Practice Address - Street 1:4325 N JOSEY LN
Practice Address - Street 2:PLAZA III STE.206
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-4635
Practice Address - Country:US
Practice Address - Phone:972-939-7246
Practice Address - Fax:972-394-0293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9920208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F5439Medicare PIN
TXH02429Medicare UPIN