Organization
TEXAS INTERVENTIONAL PAIN CARE, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARILYN J MEARON (OFFICE MANAGER)
(972) 952-0290
Entity
Organization
Contact information
Practice address
375 MUNICIPAL DR, SUITE 242, RICHARDSON, TX 75080-3559
(972) 952-0290
(972) 952-0293
Mailing address
375 MUNICIPAL DR, SUITE 242, RICHARDSON, TX 75080-3559
(972) 952-0290
(972) 952-0293
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
L5788
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002KD
BLUE CROSS BLUE SHIELD
TX
Enumeration date
12/28/2007
Last updated
01/28/2008
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