Organization
INTERVENTIONAL PAIN SOLUTIONS, PA.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY NICHOLE MAWBY (PRACTICE MANAGER)
(972) 956-5541
Entity
Organization
Contact information
Practice address
825 WEST ROYAL LANE, #230, IRVING, TX 75039
(972) 956-5541
(972) 956-5504
Mailing address
825 WEST ROYAL LANE, #230, IRVING, TX 75039
(972) 956-5541
(972) 956-5504
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
M6482
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6617390001
PTAN FOR DME
TX
Enumeration date
09/16/2009
Last updated
12/04/2012
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