Provider Demographics
NPI:1174106108
Name:UNITED PAIN PLLC
Entity type:Organization
Organization Name:UNITED PAIN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:LOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:512-215-3256
Mailing Address - Street 1:12345 N LAMAR BLVD STE 137
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78753-1338
Mailing Address - Country:US
Mailing Address - Phone:512-215-3256
Mailing Address - Fax:512-339-2239
Practice Address - Street 1:12345 N LAMAR BLVD STE 137
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78753-1338
Practice Address - Country:US
Practice Address - Phone:512-215-3256
Practice Address - Fax:512-339-2239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty