Organization
WADE INTERVENTIONAL PAIN CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY WALLS (MANAGER)
(479) 234-4740
Entity
Organization
Contact information
Practice address
17051 DALLAS PARKWAY, STE 100, ADDISON, TX 75001
(469) 916-0521
(972) 234-0212
Mailing address
PO BOX 674040, DALLAS, TX 75267-4040
(972) 479-1115
(972) 479-1118
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
—
—
Other
Enumeration date
08/07/2013
Last updated
08/07/2013
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