Provider Demographics
NPI:1710065149
Name:PAIN SPECIALTY CONSULTANTS, PA
Entity Type:Organization
Organization Name:PAIN SPECIALTY CONSULTANTS, PA
Other - Org Name:PAIN SPECIALTY CONSULTANTS, PA
Other - Org Type:Other Name
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PRAFULLA
Authorized Official - Middle Name:C
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-527-1166
Mailing Address - Street 1:PO BOX 12952
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-0952
Mailing Address - Country:US
Mailing Address - Phone:210-527-1166
Mailing Address - Fax:210-527-1163
Practice Address - Street 1:1200 BROOKLYN AVE STE 140
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-4817
Practice Address - Country:US
Practice Address - Phone:210-527-1166
Practice Address - Fax:210-527-1163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9353207L00000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0027BROtherBLUECROSS BLUESHIELD
TX0802886-01Medicaid
TX0802886-01Medicaid
0027BRMedicare PIN