Provider Demographics
NPI:1780023507
Name:INTERVENTIONAL & PAIN MANAGEMENT CENTER, PLLC
Entity Type:Organization
Organization Name:INTERVENTIONAL & PAIN MANAGEMENT CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:
Authorized Official - First Name:SALEEM
Authorized Official - Middle Name:ZIA
Authorized Official - Last Name:CHUGHATI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-466-2175
Mailing Address - Street 1:2686 W ALTON GLOOR BLVD STE 5
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-4054
Mailing Address - Country:US
Mailing Address - Phone:956-350-5444
Mailing Address - Fax:
Practice Address - Street 1:14 EDGEWATER PL
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-1420
Practice Address - Country:US
Practice Address - Phone:956-581-0303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-14
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7334208VP0000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty