NPIMap

Organization Active NPI

Premier Pain Consultants, PLLC

  • Clinical Medical Laboratory
  • San Antonio, TX
National Provider Identifier
1538599360
Registry record updated Jan 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
PREMIER PAIN CONSULTANTS, PLLC
Practice address
2425 Babcock Rd Ste 108
San Antonio, TX 78229-4899
Phone
(210) 616-9400
Fax
(210) 616-9402
NPI assigned
Nov 14, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2014

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

Authorized official

Name
Dmitriy Buyanov, M.D.NPI 1124047261
Title
Owner
Phone
(210) 616-9400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

2425 Babcock Rd Ste 108
San Antonio, TX 78229-4899

Mailing address

2425 Babcock Rd Ste 108
San Antonio, TX 78229-4899
Phone (210) 616-9400

Other identifiers 1

IdentifierTypeStateIssuer
45D1093317OtherTXCLIA

Other names 1

  • Premier Pain Consultants, P.A. Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Premier Pain Consultants4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1384387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389571200000",
    "number": "1538599360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 BABCOCK RD STE 108",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294899",
            "telephone_number": "210-616-9400",
            "fax_number": "210-616-9402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 BABCOCK RD STE 108",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294899",
            "telephone_number": "210-616-9400",
            "fax_number": "210-616-9402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PAIN CONSULTANTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-14",
        "last_updated": "2014-01-13",
        "status": "A",
        "authorized_official_last_name": "BUYANOV",
        "authorized_official_first_name": "DMITRIY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-616-9400",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "45D1093317",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Pain Consultants, P.A.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2014; 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.