Provider Demographics
NPI:1942597109
Name:METROPLEX PAIN PARTNERS, PA
Entity Type:Organization
Organization Name:METROPLEX PAIN PARTNERS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MRUGESHKUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-499-4266
Mailing Address - Street 1:PO BOX 941010
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75094-1010
Mailing Address - Country:US
Mailing Address - Phone:972-499-4266
Mailing Address - Fax:972-591-4605
Practice Address - Street 1:6957 W PLANO PKWY
Practice Address - Street 2:SUITE 2600
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-1620
Practice Address - Country:US
Practice Address - Phone:972-499-4266
Practice Address - Fax:972-591-4605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-07
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF6873207LP2900X
TXL61742081P2900X
TXN27382081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty