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Organization

GRAPEVINE PAIN MANAGEMENT, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GAIL S MAYFIELD (PRESIDENT/CEO)
(817) 479-0800
Entity
Organization

Contact information

Practice address
2401 IRA E WOODS AVE, SUITE 700, GRAPEVINE, TX 76051-3997
(817) 488-9991
(817) 488-9992
Mailing address
5750 RUFE SNOW DR, SUITE 108, NORTH RICHLAND HILLS, TX 76180-6163
(817) 479-0800
(817) 479-0801

Taxonomy

Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
261QR0200X
Radiology Clinic/Center
Primary

Other

Enumeration date
04/29/2009
Last updated
01/25/2011
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