Spine and Pain Anesthesia LLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

SPINE AND PAIN ANESTHESIA LLC

Practice address

1001 York Dr
Desoto, TX 75115-2083

Phone

(494) 313-0040

NPI assigned

Jun 29, 2020

Last updated

Jun 29, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Pritesh Patel, DO

Title

Owner/Physician

Phone

(494) 313-0040

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1593388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593388800000",
    "number": "1205453917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1889",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473081889",
            "telephone_number": "765-284-0493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 YORK DR",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152083",
            "telephone_number": "494-313-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE AND PAIN ANESTHESIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-29",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "PRITESH",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "494-313-0040",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in Desoto, TX
• Providers in Desoto, TX by specialty
• Anesthesiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; 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.