Provider Demographics
NPI:1679367155
Name:INTERVENTIONAL PAIN SPECIALISTS, LLC
Entity type:Organization
Organization Name:INTERVENTIONAL PAIN SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:GROS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-284-3200
Mailing Address - Street 1:PO BOX 69
Mailing Address - Street 2:
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70571-0069
Mailing Address - Country:US
Mailing Address - Phone:337-284-3200
Mailing Address - Fax:800-207-6956
Practice Address - Street 1:1101 S COLLEGE RD STE 200
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-3038
Practice Address - Country:US
Practice Address - Phone:337-362-8101
Practice Address - Fax:337-761-1616
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTERVENTIONAL PAIN SPECIALISTS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-04-08
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1049999Medicaid
LA1574881Medicaid