Organization
EAST INTERVENTIONAL PAIN & REGENERATIVE MEDICINE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHNNY W EAST DO (OWNER)
(214) 505-0833
Entity
Organization
Contact information
Practice address
16633 DALLAS PKWY STE 150, ADDISON, TX 75001-6812
(972) 380-0000
(972) 380-0030
Mailing address
4300 MACARTHUR AVE STE 150, DALLAS, TX 75209-6544
(214) 666-8386
(214) 666-8386
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
01/18/2021
Last updated
01/18/2021
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