Organization
METROPLEX PAIN MANAGEMENT, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANNY L STANTON (CFO)
(817) 268-0104
Entity
Organization
Contact information
Practice address
1600 CENTRAL DR, SUITE 160, BEDFORD, TX 76022-6000
(817) 268-0104
(817) 268-6102
Mailing address
1600 CENTRAL DRIVE, SUITE 160, BEDFORD, TX 76022-6029
(817) 268-0104
(817) 268-6102
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0014K
RAILROAD MEDICARE CRNA GR
—
01
—
00C09P
BCBS CRNA GROUP #
TX
05
—
090101901
—
TX
01
—
180403400
DEPT OF LABOR CRNA GROUP
—
01
—
203080
EEOICP WC
—
Enumeration date
12/22/2006
Last updated
07/03/2012
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