Basic Information
| Provider Information | |||||||||
| NPI: | 1477939320 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PREMIER PAIN SOLUTIONS PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8390 LYNDON B JOHNSON FWY STE 1000 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752431288 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9722003663 | ||||||||
| FaxNumber: | 9727599060 | ||||||||
| Practice Location | |||||||||
| Address1: | 8390 LYNDON B JOHNSON FWY STE 1000 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752431288 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9722003663 | ||||||||
| FaxNumber: | 9727599060 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/03/2015 | ||||||||
| LastUpdateDate: | 09/30/2022 | ||||||||
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| AuthorizedOfficialLastName: | KATYAL | ||||||||
| AuthorizedOfficialFirstName: | SUMIT | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 9373617243 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 09/30/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208VP0014X | P1883 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine |
No ID Information.