Organization
PREMIER PAIN CONSULTANTS, PLLC
Active
Other names
Premier Pain Consultants, P.A.
Organization subpart
No
Provider details
NPI number
Authorized official
DMITRIY BUYANOV M.D. (OWNER)
(210) 616-9400
Entity
Organization
Contact information
Practice address
2425 BABCOCK RD STE 108, SAN ANTONIO, TX 78229-4899
(210) 616-9400
(210) 616-9402
Mailing address
2425 BABCOCK RD STE 108, SAN ANTONIO, TX 78229-4899
(210) 616-9400
(210) 616-9402
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45D1093317
CLIA
TX
Enumeration date
11/14/2013
Last updated
01/13/2014
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