Organization
BURLESON INTERVENTIONAL PAIN CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TED GROSBECK (MANAGER)
(469) 362-6909
Entity
Organization
Contact information
Practice address
1805 OWEN CT, SUITE 119, MANSFIELD, TX 76063-4232
(972) 234-4740
(972) 231-7095
Mailing address
PO BOX 674147, DALLAS, TX 75267-4147
(972) 234-4740
(972) 231-7095
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
10/27/2011
Last updated
06/06/2016
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