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Organization

ALLIED PAIN MANAGEMENT CLINIC P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AMY J. BLANTON (OFFICE MANAGER)
(903) 595-6078
Entity
Organization

Contact information

Practice address
5201 S BROADWAY AVE, SUITE 200, TYLER, TX 75703-3748
(903) 595-6078
(903) 509-2545
Mailing address
5201 S BROADWAY AVE, SUITE 200, TYLER, TX 75703-3748
(903) 595-6078
(903) 509-2545

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
30239
TX
111N00000X
Chiropractor
DC5099
TX
207Q00000X
Family Medicine Physician
Primary
H4166
TX
207QG0300X
Geriatric Medicine (Family Medicine) Physician
H4166
TX
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
H4166
TX
208VP0000X
Pain Medicine Physician
H4166
TX

Other

Enumeration date
09/19/2007
Last updated
10/27/2007
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