Organization
INTEGRATIVE PAIN INSTITUTE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWNA BOUDREAUX (VP OPERATIONS)
(469) 422-0641
Entity
Organization
Contact information
Practice address
15110 DALLAS PKWY STE 102, DALLAS, TX 75248-4601
(972) 349-1333
(972) 792-0290
Mailing address
15110 DALLAS PKWY STE 102, DALLAS, TX 75248-4601
(972) 302-3489
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Q9070
TX
208D00000X
General Practice Physician
Primary
Q9070
TX
208VP0014X
Interventional Pain Medicine Physician
Q9070
TX
Other
Enumeration date
08/05/2016
Last updated
02/07/2019
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