Wade Interventional Pain Center LLC

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

Legal business name

WADE INTERVENTIONAL PAIN CENTER LLC

Practice address

17051 Dallas Parkway
Ste 100
Addison, TX 75001

Phone

(469) 916-0521

Fax

(972) 234-0212

NPI assigned

Aug 7, 2013

Organization subpart

No

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

Authorized official

Name

Tracy Walls

Title

Manager

Phone

(479) 234-4740

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1375833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375833600000",
    "number": "1609208065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 674040",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752674040",
            "telephone_number": "972-479-1115",
            "fax_number": "972-479-1118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17051 DALLAS PARKWAY",
            "address_2": "STE 100",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "75001",
            "telephone_number": "469-916-0521",
            "fax_number": "972-234-0212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WADE INTERVENTIONAL PAIN CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-07",
        "last_updated": "2013-08-07",
        "status": "A",
        "authorized_official_last_name": "WALLS",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "479-234-4740"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vision 4 Students
• Viva Clinical Health
• April K Votaw
• Katrina D Vu
• Matthew Vu, DPM
• Karen Wade, M.S., CCC-SLP
• Aliyah Waggner
• Kazima Wajahat
• Eboni Nichole Waldon Simmons
• Mark Waldrop, PHARMD

• Pain Clinic/Center in Addison, TX
• Providers in Addison, 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 Aug 7, 2013; 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.