Provider Demographics
NPI:1174386999
Name:PAIN MANAGEMENT ASSOCIATES OF TEXAS
Entity type:Organization
Organization Name:PAIN MANAGEMENT ASSOCIATES OF TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:DYER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:214-632-5184
Mailing Address - Street 1:927 IRONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-2127
Mailing Address - Country:US
Mailing Address - Phone:214-632-5184
Mailing Address - Fax:
Practice Address - Street 1:1770 E BROAD ST STE 102
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-9145
Practice Address - Country:US
Practice Address - Phone:817-442-6482
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty