Provider Demographics
NPI:1578994703
Name:GREENTREE HEALTH PAIN MANAGEMENT
Entity Type:Organization
Organization Name:GREENTREE HEALTH PAIN MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR RCM DIVISION
Authorized Official - Prefix:
Authorized Official - First Name:NATHALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACKSTOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-788-3411
Mailing Address - Street 1:8900 SHOAL CREEK BVLD BLDG 200
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757
Mailing Address - Country:US
Mailing Address - Phone:512-788-3411
Mailing Address - Fax:512-375-3865
Practice Address - Street 1:8900 SHOAL CREEK BVLD
Practice Address - Street 2:BLDG 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757
Practice Address - Country:US
Practice Address - Phone:512-788-3411
Practice Address - Fax:512-375-3865
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GREENTREE HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-12-13
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF8173208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty