Provider Demographics
NPI:1851605646
Name:METRO PAINMANAGEMENT
Entity Type:Organization
Organization Name:METRO PAINMANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-834-8214
Mailing Address - Street 1:6333 AIRPORT FWY
Mailing Address - Street 2:102
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76117-5323
Mailing Address - Country:US
Mailing Address - Phone:817-834-8211
Mailing Address - Fax:817-923-2913
Practice Address - Street 1:8204 ELMBROOK DR
Practice Address - Street 2:117
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75247-4067
Practice Address - Country:US
Practice Address - Phone:817-834-8214
Practice Address - Fax:817-923-2913
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:D & M MEDICORP,L.L.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-08-04
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD6942207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty