Organization Active NPI

Pain Specialists of Texas, LP

  • Pain Clinic/Center
  • Mansfield, TX
National Provider Identifier
1548285000
Registry record updated Apr 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
License
L5075,K3744 Issued in TX
Legal business name
PAIN SPECIALISTS OF TEXAS, LP
Practice address
1759 Broad Park Circle Street South
Suite 101
Mansfield, TX 75052-3073
Phone
(682) 518-0682
Fax
(682) 518-1334
NPI assigned
Jul 13, 2006
Last updated
Apr 26, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2011

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

Authorized official

Name
Lynne George
Title
Business Manager
Phone
(972) 606-8980

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Clinic/Center 261QP3300X L5075,K3744 TX Primary

Addresses

Primary practice location

1759 Broad Park Circle Street South
Suite 101
Mansfield, TX 75052-3073

Mailing address

1759 Broad Park Circle Street South
Suite 101
Mansfield, TX 76063
Phone (682) 518-0682

Other identifiers 1

IdentifierTypeStateIssuer
0093NJOtherTXBCBS GROUP NUMBER

National Provider Directory

National Provider Directory

Locations

4927 Lake Ridge Pkwy
Ste 170
Grand Prairie, TX 75052
Phone (817) 466-8651

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303776000000",
    "number": "1548285000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1759 BROAD PARK CIRCLE STREET SOUTH",
            "address_2": "SUITE 101",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "76063",
            "telephone_number": "682-518-0682",
            "fax_number": "682-518-1334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1759 BROAD PARK CIRCLE STREET SOUTH",
            "address_2": "SUITE 101",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "750523073",
            "telephone_number": "682-518-0682",
            "fax_number": "682-518-1334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN SPECIALISTS OF TEXAS, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2011-04-26",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "LYNNE",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "972-606-8980"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "TX",
            "license": "L5075,K3744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "0093NJ",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2011; 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.