Organization
CARROLL INTERVENTIONALPAIN CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TED GROSBECK (MANAGER)
(469) 362-6909
Entity
Organization
Contact information
Practice address
1305 AIRPORT FWY, SUITE 103, BEDFORD, TX 76021-6605
(817) 571-2607
(817) 571-0897
Mailing address
PO BOX 674319, DALLAS, TX 75267-4319
(972) 479-1115
(972) 346-8015
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
01/13/2012
Last updated
06/06/2016
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