Provider Demographics
NPI:1629198296
Name:ASSOCIATES FOR PAIN MANAGEMENT P.A.
Entity Type:Organization
Organization Name:ASSOCIATES FOR PAIN MANAGEMENT P.A.
Other - Org Name:PAIN MANAGEMENT ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:K
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-796-7246
Mailing Address - Street 1:10905 QUAKER AVE
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-8315
Mailing Address - Country:US
Mailing Address - Phone:806-796-7246
Mailing Address - Fax:806-791-1462
Practice Address - Street 1:10905 QUAKER AVE
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-8315
Practice Address - Country:US
Practice Address - Phone:806-796-7246
Practice Address - Fax:806-791-1462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH7850207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00F80LMedicare PIN
TXD93032Medicare UPIN