Organization
PAIN SPECIALISTS OF TEXAS, LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNNE GEORGE (BUSINESS MANAGER)
(972) 606-8980
Entity
Organization
Contact information
Practice address
1759 BROAD PARK CIRCLE STREET SOUTH, SUITE 101, MANSFIELD, TX 75052-3073
(682) 518-0682
(682) 518-1334
Mailing address
1759 BROAD PARK CIRCLE STREET SOUTH, SUITE 101, MANSFIELD, TX 76063
(682) 518-0682
(682) 518-1334
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
L5075,K3744
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0093NJ
BCBS GROUP NUMBER
TX
Enumeration date
07/13/2006
Last updated
04/26/2011
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