Provider Demographics
NPI:1639696016
Name:HEALTH AND PAIN MEDICINE INSTITUTE, P.A.
Entity type:Organization
Organization Name:HEALTH AND PAIN MEDICINE INSTITUTE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OLUWASOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:OLAMIKAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-489-7652
Mailing Address - Street 1:3900 TELEPORT BLVD UNIT 143361
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75014-0239
Mailing Address - Country:US
Mailing Address - Phone:503-489-7652
Mailing Address - Fax:
Practice Address - Street 1:1700 PACIFIC AVE STE 260
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-7478
Practice Address - Country:US
Practice Address - Phone:503-489-7652
Practice Address - Fax:877-778-5117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-25
Last Update Date:2017-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP1378207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric AnesthesiologyGroup - Multi-Specialty