Organization
ALLIANCE INTERVENTIONAL PAIN CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY WALLS (PRESIDENT)
(972) 788-7500
Entity
Organization
Contact information
Practice address
1305 AIRPORT FWY STE 103, BEDFORD, TX 76021-6603
(972) 234-4740
(972) 231-7095
Mailing address
PO BOX 674367, DALLAS, TX 75267-4367
(972) 234-4740
(972) 231-7095
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
07/08/2014
Last updated
06/06/2016
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