Provider Demographics
NPI:1588233738
Name:DALLAS PAIN AND SPINE INSTITUTE
Entity Type:Organization
Organization Name:DALLAS PAIN AND SPINE INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BASEM
Authorized Official - Middle Name:AHEMED
Authorized Official - Last Name:ABDELFATTAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-241-0997
Mailing Address - Street 1:PO BOX 497319
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75049-7319
Mailing Address - Country:US
Mailing Address - Phone:972-999-1659
Mailing Address - Fax:205-729-5887
Practice Address - Street 1:3453 SAINT FRANCIS AVE STE 125
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228-6098
Practice Address - Country:US
Practice Address - Phone:972-999-1659
Practice Address - Fax:205-729-5887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical