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Organization

INTERVENTIONAL SPINE & PAIN, LLP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PABLO ZEBALLOS MD (OWNER)
(219) 218-2484
Entity
Organization

Contact information

Practice address
8222 DOUGLAS AVENUE, STE. 890, DALLAS, TX 75225-7036
(214) 888-3900
(972) 681-8727
Mailing address
ATTN: CYNTHIA REYNOLDS CREDENTIALER, 18670 GRAPHICS DR. STE. 100, TINLEY PARK, IL 60477-6653
(708) 228-4262
(708) 314-7505

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
208VP0014X
Interventional Pain Medicine Physician
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Enumeration date
07/23/2017
Last updated
12/07/2018
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