# ALLIED PAIN MANAGEMENT CLINIC P.A.

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

## Provider details

- **NPI number:** 1568658920
- **Authorized official:** AMY J. BLANTON (OFFICE MANAGER)
- **Authorized official phone:** (903) 595-6078

## Contact information

- **Practice address:** 5201 S BROADWAY AVE, SUITE 200, TYLER, TX 75703-3748
- **Practice address phone:** (903) 595-6078
- **Practice address fax:** (903) 509-2545
- **Mailing address:** 5201 S BROADWAY AVE, SUITE 200, TYLER, TX 75703-3748
- **Mailing address phone:** (903) 595-6078
- **Mailing address fax:** (903) 509-2545

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | 30239 | TX | — |
| 111N00000X | Chiropractor | DC5099 | TX | — |
| 207Q00000X | Family Medicine Physician | H4166 | TX | Yes |
| 207QG0300X | Geriatric Medicine (Family Medicine) Physician | H4166 | TX | — |
| 207QH0002X | Hospice and Palliative Medicine (Family Medicine) Physician | H4166 | TX | — |
| 208VP0000X | Pain Medicine Physician | H4166 | TX | — |

## Other

- **Enumeration date:** 09/19/2007
- **Last updated:** 10/27/2007