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Organization

VIDABUENAMED, PLLC

Active
Other names
DFW Interventional Pain Institute
Organization subpart
No

Provider details

NPI number
Authorized official
EDRICK LOPEZ MD (OWNER)
(469) 648-3832
Entity
Organization

Contact information

Practice address
1110 COTTONWOOD LN STE 150, IRVING, TX 75038-6117
(469) 648-3832
(469) 648-3812
Mailing address
PO BOX 837, HOWE, TX 75459-0837
(469) 648-3832
(469) 648-3812

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician

Other

Enumeration date
05/31/2023
Last updated
05/31/2023
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