Provider Demographics
NPI:1700226867
Name:DALLAS PAIN RELIEF CENTER, PC.
Entity Type:Organization
Organization Name:DALLAS PAIN RELIEF CENTER, PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:ALIBERTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-872-4492
Mailing Address - Street 1:5501 W GRAY ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-1007
Mailing Address - Country:US
Mailing Address - Phone:813-872-4492
Mailing Address - Fax:813-870-1502
Practice Address - Street 1:5944 W PARKER RD
Practice Address - Street 2:SUITE 300
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-6421
Practice Address - Country:US
Practice Address - Phone:813-872-4492
Practice Address - Fax:813-870-1502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-03
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN6976174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty