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Organization

DICKERSON DALLAS PAIN ON PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID JANWAY LPC (COO)
(972) 850-9179
Entity
Organization

Contact information

Practice address
1675 REPUBLIC PKWY STE 201, MESQUITE, TX 75150-6902
(972) 850-9179
(877) 720-5614
Mailing address
1675 REPUBLIC PKWY, STE 201, MESQUITE, TX 75150-6902
(713) 355-1500
(713) 629-1945

Taxonomy

Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
261QR0400X
Rehabilitation Clinic/Center

Other

Enumeration date
04/05/2019
Last updated
02/04/2021
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