White Rock Interventional Pain Center LLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

WHITE ROCK INTERVENTIONAL PAIN CENTER LLC

Practice address

17051 Dallas Pkwy
Suite 100
Addison, TX 75001-7109

Phone

(469) 916-0521

NPI assigned

Jun 19, 2015

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

President

Phone

(469) 916-0521

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461110400000",
    "number": "1932581576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 674156",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752674156",
            "telephone_number": "469-916-0521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17051 DALLAS PKWY",
            "address_2": "SUITE 100",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750017109",
            "telephone_number": "469-916-0521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE ROCK INTERVENTIONAL PAIN CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-19",
        "last_updated": "2016-04-20",
        "status": "A",
        "authorized_official_last_name": "WALLS",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "469-916-0521"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• West Plano Anesthesia PLLC
• West Plano Interventional Spine and Procedure Center LLC
• Abbey Kate West
• Brooke Erin West, PHD LPC-S, RPT-S
• Westminster Interventional Pain Center LLC
• Audra White, NRCMA
• Caroline Wieck, M.S., CCC-SLP
• Holly Wiese
• Charleen Wilder
• Alesha Lizzette Williams, LPC

• Certified Registered Nurse Anesthetist in Addison, TX
• Providers in Addison, 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 Apr 20, 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.