Organization
SOUTHWESTERN PAIN INSTITUTE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL SHALEV M.D. (PAIN MANAGEMENT)
(972) 980-4400
Entity
Organization
Contact information
Practice address
5744 LYNDON B JOHNSON FWY, SUITE 175, DALLAS, TX 75240-6322
(972) 980-4400
(972) 980-4100
Mailing address
PO BOX 803311, DALLAS, TX 75380-3311
(972) 980-4400
(972) 980-4100
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0021DM
BLUE CROSS BLUE SHIELD
TX
Enumeration date
02/13/2007
Last updated
05/19/2009
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