Provider Demographics
NPI:1639904857
Name:CORE PAIN MANAGEMENT
Entity type:Organization
Organization Name:CORE PAIN MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIA MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:TARIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-625-9018
Mailing Address - Street 1:205 W BELT LINE RD
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-2008
Mailing Address - Country:US
Mailing Address - Phone:214-625-9018
Mailing Address - Fax:
Practice Address - Street 1:4441 W AIRPORT FWY STE 210
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-5840
Practice Address - Country:US
Practice Address - Phone:214-214-7246
Practice Address - Fax:817-977-7390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty