Organization Active NPI

Interventional Pain Solutions, PA.

  • Interventional Pain Medicine Physician
  • Irving, TX
National Provider Identifier
1780917179
Registry record updated Dec 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
M6482 Issued in TX
Legal business name
INTERVENTIONAL PAIN SOLUTIONS, PA.
Practice address
825 West Royal Lane
#230
Irving, TX 75039
Phone
(972) 956-5541
Fax
(972) 956-5504
NPI assigned
Sep 16, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2012

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

Authorized official

Name
Ashley Nichole Mawby
Title
Practice Manager
Phone
(972) 956-5541

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X M6482 TX Primary

Addresses

Primary practice location

825 West Royal Lane
#230
Irving, TX 75039

Mailing address

825 West Royal Lane
#230
Irving, TX 75039
Phone (972) 956-5541

Other identifiers 1

IdentifierTypeStateIssuer
6617390001OtherTXPTAN FOR DME

National Provider Directory

National Provider Directory

Locations

3611 Morriss Rd
Flower Mound, TX 75028
Phone (214) 620-7444

5450 Clearfork Main St
Ste 230
Fort Worth, TX 76109
Phone (817) 641-6000

NPI Registry JSON

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

{
    "created_epoch": "1253059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354579200000",
    "number": "1780917179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 WEST ROYAL LANE",
            "address_2": "#230",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "75039",
            "telephone_number": "972-956-5541",
            "fax_number": "972-956-5504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 WEST ROYAL LANE",
            "address_2": "#230",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "75039",
            "telephone_number": "972-956-5541",
            "fax_number": "972-956-5504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERVENTIONAL PAIN SOLUTIONS, PA.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-16",
        "last_updated": "2012-12-04",
        "status": "A",
        "authorized_official_last_name": "MAWBY",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "NICHOLE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "972-956-5541"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "TX",
            "license": "M6482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN FOR DME",
            "identifier": "6617390001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2012; 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.