Provider Demographics
NPI:1912605429
Name:MEDWAY PAIN CENTER LLC
Entity Type:Organization
Organization Name:MEDWAY PAIN CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TOCHI
Authorized Official - Middle Name:
Authorized Official - Last Name:UMUNAKWE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-218-4104
Mailing Address - Street 1:7101 N MESA ST # 317
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-3613
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1397 GEORGE DIETER DR STE D
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-7681
Practice Address - Country:US
Practice Address - Phone:915-218-4104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty