Burleson Interventional Pain Center, LLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

BURLESON INTERVENTIONAL PAIN CENTER, LLC

Practice address

1805 Owen CT
Suite 119
Mansfield, TX 76063-4232

Phone

(972) 234-4740

Fax

(972) 231-7095

NPI assigned

Oct 27, 2011

Last updated

Jun 6, 2016By 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

Ted Grosbeck

Title

Manager

Phone

(469) 362-6909

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1319673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465171200000",
    "number": "1356627988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 674147",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752674147",
            "telephone_number": "972-234-4740",
            "fax_number": "972-231-7095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 OWEN CT",
            "address_2": "SUITE 119",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760634232",
            "telephone_number": "972-234-4740",
            "fax_number": "972-231-7095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURLESON INTERVENTIONAL PAIN CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-27",
        "last_updated": "2016-06-06",
        "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": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jillian Elaine Burke, M.S., CCC-SLP
• Mary Courtney Burken, ATC LAT PHD
• Richard J Burkett, M.D., P.A.
• Burks Medical Consulting
• Erika Burks
• Shaquayla Burns, LMSW
• Kimara Latoya Burnside
• Sean Verlin Burt, RN
• Melody Burton, D.O.
• Elizabeth A Busch, PA-C

• Certified Registered Nurse Anesthetist in Mansfield, TX
• Providers in Mansfield, TX by specialty
• Certified Registered Nurse Anesthetist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2016; 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.