Organization
PREMIER PAIN CONSULTANTS, PA
Active
Parent organization
PREMIER PAIN CONSULTANTS, PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
PREMIER PAIN CONSULTANTS, PA
Authorized official
ILLIANA GALVAN-COBOS (CREDENTIAL COORDINATOR)
(210) 616-9400
Entity
Organization
Contact information
Practice address
1650 LOCKHILL SELMA RD, SAN ANTONIO, TX 78213-1929
(210) 616-9400
(210) 616-9402
Mailing address
PO BOX 26, SAN ANTONIO, TX 78291
(210) 616-9400
(210) 616-9402
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
L7996
TX
207LP2900X
Pain Medicine (Anesthesiology) Physician
M2907
TX
207LP2900X
Pain Medicine (Anesthesiology) Physician
N3706
TX
Other
Enumeration date
04/06/2011
Last updated
04/06/2011
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