Provider Demographics
NPI:1851741011
Name:INTERVENTIONAL PAIN, ONCOLOGY, AND ENDOVASCULAR INSTITUTE
Entity Type:Organization
Organization Name:INTERVENTIONAL PAIN, ONCOLOGY, AND ENDOVASCULAR INSTITUTE
Other - Org Name:INTERVENTIONAL AND VASCULAR INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RABIN
Authorized Official - Middle Name:
Authorized Official - Last Name:NOURANIFAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:866-731-0712
Mailing Address - Street 1:PO BOX 12973
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79913-0973
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7049 WESTWIND DR APT 6011A
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-1736
Practice Address - Country:US
Practice Address - Phone:866-731-0712
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-20
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty