Provider Demographics
NPI:1720419617
Name:BALCONES PAIN CONSULTANTS
Entity Type:Organization
Organization Name:BALCONES PAIN CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT/SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:ANGUS
Authorized Official - Middle Name:
Authorized Official - Last Name:LOWRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-834-4141
Mailing Address - Street 1:4544 S LAMAR BLVD
Mailing Address - Street 2:SUITE 700
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-1500
Mailing Address - Country:US
Mailing Address - Phone:512-834-4141
Mailing Address - Fax:512-834-4142
Practice Address - Street 1:181 CIMARRON PARK LOOP
Practice Address - Street 2:STE A
Practice Address - City:BUDA
Practice Address - State:TX
Practice Address - Zip Code:78610-2852
Practice Address - Country:US
Practice Address - Phone:512-834-4141
Practice Address - Fax:512-834-4142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-03
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9787208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty