Provider Demographics
NPI:1972570414
Name:THE HEADACHE & PAIN CENTER, P. A.
Entity type:Organization
Organization Name:THE HEADACHE & PAIN CENTER, P. A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAURICIO
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-387-3111
Mailing Address - Street 1:8101 W 135TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223-1111
Mailing Address - Country:US
Mailing Address - Phone:913-491-3999
Mailing Address - Fax:913-491-9309
Practice Address - Street 1:8101 W 135TH ST STE 200
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66223-1111
Practice Address - Country:US
Practice Address - Phone:913-491-3999
Practice Address - Fax:913-491-9309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-03
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSS046003261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO502126006Medicaid
KS100379590BMedicaid
MO502126006Medicaid