Provider Demographics
NPI:1841766169
Name:CAPITOL INTERVENTIONAL PAIN MANAGEMENT PLLC
Entity Type:Organization
Organization Name:CAPITOL INTERVENTIONAL PAIN MANAGEMENT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:512-832-4999
Mailing Address - Street 1:12180 N MOPAC EXPY STE B
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-2909
Mailing Address - Country:US
Mailing Address - Phone:512-832-4999
Mailing Address - Fax:512-836-8801
Practice Address - Street 1:12180 N MOPAC EXPY STE B
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-2909
Practice Address - Country:US
Practice Address - Phone:512-832-4999
Practice Address - Fax:512-836-8801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-15
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty