Provider Demographics
NPI:1962454595
Name:CLINIC FOR PAIN MANAGEMENT
Entity Type:Organization
Organization Name:CLINIC FOR PAIN MANAGEMENT
Other - Org Name:CENTER FOR PAIN RELIEF
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-637-0887
Mailing Address - Street 1:700 HIGHLANDER BLVD STE 415
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-4346
Mailing Address - Country:US
Mailing Address - Phone:817-516-8811
Mailing Address - Fax:817-516-8444
Practice Address - Street 1:6750 N MACARTHUR BLVD STE 205
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-2470
Practice Address - Country:US
Practice Address - Phone:214-637-0887
Practice Address - Fax:817-516-8444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX159243801Medicaid