Provider Demographics
NPI:1013300862
Name:KAUFMAN ORTHOPEDIC PAIN MANAGEMENT, PLLC
Entity type:Organization
Organization Name:KAUFMAN ORTHOPEDIC PAIN MANAGEMENT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THEODOOR
Authorized Official - Middle Name:CHRISTIAAN
Authorized Official - Last Name:HANCHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-205-4655
Mailing Address - Street 1:4000 OLD JACKSBORO HWY
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76302-2134
Mailing Address - Country:US
Mailing Address - Phone:940-500-4048
Mailing Address - Fax:833-320-1559
Practice Address - Street 1:4000 OLD JACKSBORO HWY
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76302-2134
Practice Address - Country:US
Practice Address - Phone:940-500-4048
Practice Address - Fax:833-320-1559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-17
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty