Provider Demographics
NPI:1639736903
Name:TD PAIN SERVICES PLLC
Entity Type:Organization
Organization Name:TD PAIN SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TERAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-549-8284
Mailing Address - Street 1:3728 SHADY HILL DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75229-2711
Mailing Address - Country:US
Mailing Address - Phone:918-549-8284
Mailing Address - Fax:877-576-0804
Practice Address - Street 1:3728 SHADY HILL DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75229-2711
Practice Address - Country:US
Practice Address - Phone:918-549-8284
Practice Address - Fax:877-576-0804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-22
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty