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Organization

TRINITY PAIN MEDICINE ASSOCIATES PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ASHLEY M CLASSEN D.O. (MEDICAL DIRECTOR)
(817) 332-3664
Entity
Organization

Contact information

Practice address
1401 HENDERSON ST, FORT WORTH, TX 76102-6026
(817) 332-3664
(817) 336-6440
Mailing address
PO BOX 9290, FORT WORTH, TX 76147-2290
(817) 332-3664
(817) 336-6440

Taxonomy

Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0040CG
GROUP NUMBER
TX
05
079577501
TX
Enumeration date
09/20/2006
Last updated
01/09/2009
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