Provider Demographics
NPI:1942869284
Name:BALCONES PAIN CENTER
Entity Type:Organization
Organization Name:BALCONES PAIN CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:WEAVER
Authorized Official - Last Name:SPANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-834-4141
Mailing Address - Street 1:5656 BEE CAVES RD STE K200
Mailing Address - Street 2:
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5811
Mailing Address - Country:US
Mailing Address - Phone:512-329-6644
Mailing Address - Fax:512-891-8220
Practice Address - Street 1:5200 DAVIS LN STE B200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78749-4069
Practice Address - Country:US
Practice Address - Phone:512-834-4141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty