INTERVENTIONAL PAIN MANAGEMENT, PA (NPI# 1114113669) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114113669 |
| Entity Type | Organization |
| Organization Name | INTERVENTIONAL PAIN MANAGEMENT, PA |
| Practice Address |
3312 N University Dr Suite J Nacogdoches TX 75965-2637 |
| Practice Telephone | 9365602222 |
| Practice Fax Number | 9365691788 |
| Mailing Telephone | (936) 560-2222 |
| Mailing Fax Number | 9365691788 |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2017-07-05 |
| Authorized Official Name | JAMES D DAVIS (MD/OWNER) |
| Authorized Official Telephone | 9365602222 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | INTERVENTIONAL PAIN MANAGEMENT, PA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
J8185 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PALMETTO GBA | DF4810 | 01 | |
| TX | 184657801 | 05 |
| Street Address |
3312 N UNIVERSITY DR SUITE J |
| City | NACOGDOCHES |
| State | TX |
| Zip Code | 75965-2637 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255313581 | James Donald Davis | Anesthesiology | 3312 N University Dr, Suite J, Nacogdoches, TX 75965-2637 | 2005-11-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649839135 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 3824 N University Drive, Suite 103, Nacogdoches, TX 75965 | 2019-06-10 |
| 1518520493 | Billy Jobe | Pharmacist | 917 East Austin, Nacogdoches, TX 75965 | 2019-04-17 |
| 1295217610 | Sarah Ponder | Registered Nurse | 625 Woodway Lane, Nacogdoches, TX 75965 | 2018-09-01 |
| 1083107684 | Aakash Deep Gupta | Dentist | 4610 North St Ste 101b, Nacogdoches, TX 75965 | 2018-06-08 |
| 1679097455 | Emily Morris Taravella | Counselor | 3524 Ne Stallings Drive, Nacogdoches, TX 75965 | 2017-08-02 |
| 1457809949 | Kassey Osborn | Nurse Practitioner | 4920 Ne Stallings Dr., Nacogdoches Medical Center, Nacogdoches, TX 75965 | 2016-09-14 |
| 1629426747 | Lisa Greathouse | Technician, Other | 500 Chincapin, Westville, OK 75965 | 2016-05-31 |
| 1457741704 | Nuch of Texas | Pediatrics | 1305 North Street, Nacogdoches, TX 75965 | 2015-01-26 |
| 1730506031 | Benjamin Patrick Thompson | Obstetrics & Gynecology | 4800 Ne Stallings Dr Ste 106, Nacogdoches, TX 75965 | 2014-03-25 |
| 1255761813 | Kallie Krawietz | Counselor | 2214 N Pecan Street, Nacogdoches, TX 75965 | 2013-11-19 |
| Find all providers in zip 75965 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285612689 | Eduardo Sy Tanhui | Anesthesiology | 3440 Ne Stallings Dr, Nacogdoches, TX 75965-8719 | 2006-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265033930 | Phuong Dinh Nguyen | Anesthesiology | 11726 E Streamertail Cir # 2, Cypress, TX 77433-6732 | 2020-11-08 |
| 1699375576 | Prwcswtx LLC | Anesthesiology | 700 Paredes Ave Ste 107, Brownsville, TX 78521-2169 | 2020-10-29 |
| 1235742388 | Tricity Pain Associates Pa | Anesthesiology | 14800 San Pedro Ave Ste 115, San Antonio, TX 78232-3734 | 2020-08-28 |
| 1669081915 | Laila Pm&a Group Inc | Anesthesiology | 1803 Longwood Ct, Allen, TX 75013-3074 | 2020-07-23 |
| 1164050498 | Manuel Ybarra Md | Anesthesiology | 255 E Sonterra Blvd Ste 203, San Antonio, TX 78258-4076 | 2020-03-31 |
| 1104451079 | Daniel Dalton Dubose, Md, Pa | Anesthesiology | 201 Crown Pointe Blvd Ste 200, Willow Park, TX 76087-1304 | 2020-03-11 |
| 1700423738 | Esplanade Medical Services Pllc | Anesthesiology | 2024 W 15th St # F-366, Plano, TX 75075-7363 | 2019-12-10 |
| 1760027700 | Sameer Syed, Md, Pa | Anesthesiology | 3151 W 15th St Ste B, Plano, TX 75075-7731 | 2019-11-13 |
| 1518501030 | Institute of Precision Pain Medicine, Pllc | Anesthesiology | 13725 Northwest Blvd Ste 120a, Corpus Christi, TX 78410-3743 | 2019-10-29 |
| 1629628672 | Yancey Pain & Spine, Lllp | Anesthesiology | 9200 Pinecroft Dr Ste 330, Shenandoah, TX 77380-3279 | 2019-09-11 |
| Find all providers with the same taxonomy | ||||
| City | NACOGDOCHES |
| Zip Code | 75965 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.