Organization
HENDERSON INTERVENTIONAL PAIN CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY WALLS (PRESIDENT)
(972) 234-4740
Entity
Organization
Contact information
Practice address
1201 SUMMIT AVE, SUITE 400, FT WORTH, TX 76102-4413
(817) 334-0990
(817) 571-0897
Mailing address
PO BOX 674001, DALLAS, TX 75267-4001
(972) 479-1115
(972) 346-8015
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
—
—
Other
Enumeration date
01/07/2013
Last updated
01/07/2013
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