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Organization

WINDHAVEN INTERVENTIONAL PAIN CENTER, LLC

Active
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Organization

WINDHAVEN INTERVENTIONAL PAIN CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TRACY WALLS (MANAGER)
(972) 234-4740
Entity
Organization

Contact information

Practice address
17051 DALLAS PKWY, STE 100, ADDISON, TX 75001-7101
(972) 916-0521
(972) 234-0212
Mailing address
PO BOX 674267, DALLAS, TX 75267-4267
(972) 479-1115
(972) 346-8015

Taxonomy

Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—

Other

Enumeration date
04/13/2012
Last updated
06/06/2016
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