Provider Demographics
NPI:1245059518
Name:FUNCTIONAL PAIN CENTER
Entity type:Organization
Organization Name:FUNCTIONAL PAIN CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOAQUIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNOZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-655-0516
Mailing Address - Street 1:1401 E RIDGE RD STE D
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1525
Mailing Address - Country:US
Mailing Address - Phone:956-683-0234
Mailing Address - Fax:956-683-0758
Practice Address - Street 1:1401 E RIDGE RD STE D
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1525
Practice Address - Country:US
Practice Address - Phone:956-683-0234
Practice Address - Fax:956-683-0758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-04
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)