Organization
SHORESIDE INTERVENTIONAL PAIN LLC
Active
Organization
SHORESIDE INTERVENTIONAL PAIN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN A. IRWIN MD (OWNER)
(479) 268-6090
Entity
Organization
Contact information
Practice address
2068 HAWTHORNE ST STE 101, SARASOTA, FL 34239-2368
(941) 362-5555
(941) 362-5559
Mailing address
9330 LBJ FWY STE 800, DALLAS, TX 75243-4310
(972) 792-5700
(214) 506-1170
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
08/20/2021
Last updated
09/17/2024
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