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WEST TEXAS PAIN INSTITUTE, LLC

Ambulatory Surgical >> Clinic/Center >> Ambulatory Health Care Facilities

Registrant NPI Number: 1639370638

Organizational Registrant:
Organization Name:  WEST TEXAS PAIN INSTITUTE, LLC
Organization is not Subpart
Authorized Official:  MICHAEL  OLIVA  MANGER  806--23-94488

Location and contact information for practice:
4316 23RD ST  LUBBOCK, TX 79410-1812 US
Tel: 806-791-4588  Fax: --

Contact information for business:
4316 23RD ST  LUBBOCK, TX 79410-1812 US
Tel: 806-791-4588  Fax: --

Registration Information:
NPI: 1639370638
Entity Type: Organization

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y261QA1903XAmbulatory Health Care Facilities
Clinic/Center
Ambulatory Surgical
TX0800033644

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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