# VIDABUENAMED, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** DFW Interventional Pain Institute
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356034755
- **Authorized official:** EDRICK LOPEZ MD (OWNER)
- **Authorized official phone:** (469) 648-3832

## Contact information

- **Practice address:** 1110 COTTONWOOD LN STE 150, IRVING, TX 75038-6117
- **Practice address phone:** (469) 648-3832
- **Practice address fax:** (469) 648-3812
- **Mailing address:** PO BOX 837, HOWE, TX 75459-0837
- **Mailing address phone:** (469) 648-3832
- **Mailing address fax:** (469) 648-3812

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | — |

## Other

- **Enumeration date:** 05/31/2023
- **Last updated:** 05/31/2023