Organization
TEXAS PAIN PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BASEM ABDELFATTAH (OWNER)
(915) 241-0997
Entity
Organization
Contact information
Practice address
1712 PIONEER AVE STE 500, CHEYENNE, WY 82001-4406
(915) 241-0997
Mailing address
1712 PIONEER AVE STE 500, CHEYENNE, WY 82001-4406
Taxonomy
Speciality
Code
Description
License number
State
284300000X
Special Hospital
Primary
P9994
TX
Other
Enumeration date
06/06/2016
Last updated
06/06/2016
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