Organization
GRAYSON INTERVENTIONAL PAIN CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY WALLS (PRESIDENT)
(972) 234-4740
Entity
Organization
Contact information
Practice address
1600 W NORTHWEST HWY, GRAPEVINE, TX 76051-8112
(469) 916-0521
(972) 234-0212
Mailing address
PO BOX 674057, DALLAS, TX 75267-4057
(972) 916-0521
(972) 234-0212
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
—
—
Other
Enumeration date
09/13/2016
Last updated
09/13/2016
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