Provider Demographics
NPI:1922334861
Name:PAIN INSTITUTE OF SOUTH TEXAS,PA
Entity Type:Organization
Organization Name:PAIN INSTITUTE OF SOUTH TEXAS,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAFATH
Authorized Official - Middle Name:
Authorized Official - Last Name:QUARAISHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-682-8998
Mailing Address - Street 1:2501 BUDDY OWENS AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-5427
Mailing Address - Country:US
Mailing Address - Phone:956-682-8998
Mailing Address - Fax:
Practice Address - Street 1:2501 BUDDY OWENS AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-5427
Practice Address - Country:US
Practice Address - Phone:956-682-8998
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-28
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7374261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXK7374OtherMEDICAL LICENSE