Provider Demographics
NPI:1265155931
Name:RGV INSTITUTE OF PAIN MANAGEMENT LLC
Entity type:Organization
Organization Name:RGV INSTITUTE OF PAIN MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDRES
Authorized Official - Middle Name:MAURICIO
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-944-7194
Mailing Address - Street 1:1506 LONE STAR WAY STE 1
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539
Mailing Address - Country:US
Mailing Address - Phone:361-944-7194
Mailing Address - Fax:
Practice Address - Street 1:1506 S LONE STAR WAY STE 1
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-4977
Practice Address - Country:US
Practice Address - Phone:956-731-0409
Practice Address - Fax:956-322-4092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-19
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty