Organization
BLUEBONNET PAIN PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELANIE GROSS (VP OF REVENUE CYCLE)
(214) 615-5168
Entity
Organization
Contact information
Practice address
10740 N CENTRAL EXPY STE 275, DALLAS, TX 75231-2166
(214) 615-5168
(888) 526-9542
Mailing address
PO BOX 3837, CAROL STREAM, IL 60132-3837
(214) 615-5168
(888) 526-9542
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
06/02/2014
Last updated
06/02/2014
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