# GRAPEVINE PAIN MANAGEMENT, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558505909
- **Authorized official:** MR. GAIL S MAYFIELD (PRESIDENT/CEO)
- **Authorized official phone:** (817) 479-0800

## Contact information

- **Practice address:** 2401 IRA E WOODS AVE, SUITE 700, GRAPEVINE, TX 76051-3997
- **Practice address phone:** (817) 488-9991
- **Practice address fax:** (817) 488-9992
- **Mailing address:** 5750 RUFE SNOW DR, SUITE 108, NORTH RICHLAND HILLS, TX 76180-6163
- **Mailing address phone:** (817) 479-0800
- **Mailing address fax:** (817) 479-0801

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP3300X | Pain Clinic/Center | — | — | — |
| 261QR0200X | Radiology Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 04/29/2009
- **Last updated:** 01/25/2011