Provider Demographics
NPI:1609237072
Name:EAMES PAIN AND ANESTHESIA MANAGEMENT
Entity Type:Organization
Organization Name:EAMES PAIN AND ANESTHESIA MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:EAMES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:214-683-7838
Mailing Address - Street 1:508 WOODSTREAM PL
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-5874
Mailing Address - Country:US
Mailing Address - Phone:214-683-7838
Mailing Address - Fax:972-216-4481
Practice Address - Street 1:1301 N BEACH ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76111-6613
Practice Address - Country:US
Practice Address - Phone:817-831-3388
Practice Address - Fax:817-831-1541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-14
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXHO319261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain