Basic Information
Provider Information
NPI: 1104292689
EntityType: 2
ReplacementNPI:  
OrganizationName: TEXAS PARTNERS IN PAIN MANAGEMENT
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9720 COIT RD
Address2: 220 # 340
City: PLANO
State: TX
PostalCode: 750255833
CountryCode: US
TelephoneNumber: 9723859898
FaxNumber: 8887706360
Practice Location
Address1: 6850 TPC DR
Address2: SUITE 118
City: MCKINNEY
State: TX
PostalCode: 750703145
CountryCode: US
TelephoneNumber: 9723859898
FaxNumber: 8887706360
Other Information
ProviderEnumerationDate: 08/19/2015
LastUpdateDate: 08/19/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: YOUNAS
AuthorizedOfficialFirstName: BABER
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: MEMBER
AuthorizedOfficialTelephone: 9176856050
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207LP2900XM9757TXY193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine

No ID Information.


Home