Provider Demographics
NPI:1821254673
Name:NORTH TEXAS PAIN SPECIALISTS PA
Entity Type:Organization
Organization Name:NORTH TEXAS PAIN SPECIALISTS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:DYER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:214-632-5184
Mailing Address - Street 1:PO BOX 560993
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-0993
Mailing Address - Country:US
Mailing Address - Phone:972-668-7460
Mailing Address - Fax:972-668-7467
Practice Address - Street 1:927 IRONWOOD DR
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2127
Practice Address - Country:US
Practice Address - Phone:214-632-5184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-31
Last Update Date:2009-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3629208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty