Organization
MIDCITIES PAIN CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TED GROESBECK (VICE PRESIDENT)
(469) 682-6742
Entity
Organization
Contact information
Practice address
1600 W NORTHWEST HWY, STE. 1000, GRAPEVINE, TX 76051-8112
(817) 488-9991
Mailing address
PO BOX 269083, OKLAHOMA CITY, OK 73126-9083
(972) 479-1115
(972) 346-8013
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
261QP3300X
Pain Clinic/Center
—
—
Other
Enumeration date
10/10/2007
Last updated
08/05/2008
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