Provider Demographics
NPI:1356008171
Name:MESQUITE INTEGRATED HEALTHCARE SPCIALISTS PLLC
Entity type:Organization
Organization Name:MESQUITE INTEGRATED HEALTHCARE SPCIALISTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BART
Authorized Official - Middle Name:G
Authorized Official - Last Name:ATENCIO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:512-924-2978
Mailing Address - Street 1:12501 HYMEADOW DR STE 1F
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-1831
Mailing Address - Country:US
Mailing Address - Phone:512-924-2978
Mailing Address - Fax:512-436-8001
Practice Address - Street 1:10400 N CENTRAL EXPY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-2297
Practice Address - Country:US
Practice Address - Phone:972-884-4400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-29
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty