Organization
CARDINAL INTERVENTIONAL PAIN CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN SIMON (ACOUNT MANAGER)
(214) 642-2943
Entity
Organization
Contact information
Practice address
2717 SUMMERHILL RD, TEXARKANA, TX 75503-3957
(214) 642-2943
(877) 540-9887
Mailing address
6501 LAKEVIEW DR, TEXARKANA, TX 75503-1906
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235137019
TYPE I NPI
—
Enumeration date
11/24/2021
Last updated
02/04/2022
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