Prestonwood Pain Center, LLC

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

Legal business name

PRESTONWOOD PAIN CENTER, LLC

Practice address

1305 Airport Fwy
Suite 103
Bedford, TX 76021-6605

Phone

(972) 234-4740

Fax

(817) 571-0897

NPI assigned

Dec 11, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ted Grosbeck

Title

Manager

Phone

(469) 362-6909

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1292025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292025600000",
    "number": "1184927204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25885",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731250885",
            "telephone_number": "972-234-4740",
            "fax_number": "817-571-0897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 AIRPORT FWY",
            "address_2": "SUITE 103",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760216605",
            "telephone_number": "972-234-4740",
            "fax_number": "817-571-0897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTONWOOD PAIN CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-11",
        "last_updated": "2010-12-11",
        "status": "A",
        "authorized_official_last_name": "GROSBECK",
        "authorized_official_first_name": "TED",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "469-362-6909"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Jodell Powers, M.A. LPC
• Meenakshi Prabhakar, MD
• Roshni Pranav, DO
• Linda A Prentice, M.D.
• Nathan Prescott, D.O.
• Primary Pinnacle Diagnostic LLC
• Priya Subramanian MD PA
• Provectus Family Eyecare PLLC
• Prudentevaluations Consulting LLC
• Psychology Services of North Texas

• Pain Clinic/Center in Bedford, TX
• Providers in Bedford, TX by specialty
• Pain Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.