BURLESON INTERVENTIONAL PAIN CENTER, LLC (NPI# 1356627988) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356627988 |
| Entity Type | Organization |
| Organization Name | BURLESON INTERVENTIONAL PAIN CENTER, LLC |
| Practice Address |
1805 Owen Ct Suite 119 Mansfield TX 76063-4232 |
| Mailing Address |
Po Box 674147 Dallas TX 75267-4147 |
| Practice Telephone | 9722344740 |
| Practice Fax Number | 9722317095 |
| Mailing Telephone | 9722344740 |
| Mailing Fax Number | 9722317095 |
| Enumeration Date | 2011-10-27 |
| Last Update Date | 2016-06-06 |
| Authorized Official Name | TED GROSBECK (MANAGER) |
| Authorized Official Telephone | 4693626909 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QP3300X |
Clinic/Center Specialization: Pain |
Ambulatory Health Care Facilities | ||
| Y | 367500000X | Nurse Anesthetist, Certified Registered | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1805 OWEN CT SUITE 119 |
| City | MANSFIELD |
| State | TX |
| Zip Code | 76063-4232 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740551241 | Rendon Interventional Pain Center LLC | Clinic/Center | 1805 Owen Ct, Suite 119, Mansfield, TX 76063-4232 | 2012-01-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316558349 | Lindsey Vandyke, D.o. Pllc | Internal Medicine | 3150 E Broad Street, Ste 100, Mansfield, TX 76063 | 2020-08-13 |
| 1942819867 | Jennifer Que Chau Nguyen | Pharmacist | 980 U.S. 287 Frontage Rd #287, Mansfield, TX 76063 | 2020-07-27 |
| 1194346890 | Ana Maria Gonzalez | Dentist | 1600 Us Highway 287, Suite 102, Mansfield, TX 76063 | 2020-05-04 |
| 1245869080 | Stateserv Medical of Texas, LLC | Durable Medical Equipment & Medical Supplies | 7941 Rodeo Trail, Mansfield, TX 76063 | 2020-04-03 |
| 1649802232 | Mary Puanani Kamai | Nurse Practitioner | 1301 E. Debbie Lane, Suite 102 #1405, Mansfield, TX 76063 | 2020-02-11 |
| 1770123028 | Gladys Vera Nfodzo | Nurse Practitioner | 901 W. Broad St, Mansfield, TX 76063 | 2020-01-14 |
| 1669011300 | Alexa Smith | Nurse Practitioner | 2800 E Broad St #304, Mansfield, TX 76063 | 2019-12-28 |
| 1477190437 | Mel Rockwall LLC | Optometrist | 1701 East Broad Street, Ste 109, Mansfield, TX 76063 | 2019-12-09 |
| 1376185512 | Daniel Max & Marcandrea LLC | Optometrist | 1701 East Broad St., Ste 109, Mansfield, TX 76063 | 2019-10-09 |
| 1861046385 | Lacey Eaton | Counselor | 805 Killian Dr, Mansfield, TX 76063 | 2019-08-01 |
| Find all providers in zip 76063 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972854701 | Paul A Williams | Nurse Anesthetist, Certified Registered | 799 Lexinton Ave, Mansfield, OH 44907-1906 | 2012-09-19 |
| 1720156839 | James Brasier | Nurse Anesthetist, Certified Registered | 7364 Hinton Dr, Mansfield, TX 76063-4639 | 2006-11-30 |
| 1780298422 | Garrett Brendan Stough | Nurse Anesthetist, Certified Registered | 335 Glessner Ave, Mansfield, OH 44903-2269 | 2020-09-01 |
| 1558814103 | Keely Marie Burrer | Nurse Anesthetist, Certified Registered | 799 Lexington Ave, Mansfield, OH 44907-1906 | 2016-08-01 |
| 1043611197 | Amy Joann Secor | Nurse Anesthetist, Certified Registered | 799 Lexington Ave, Mansfield, OH 44907-1906 | 2014-09-09 |
| 1306278445 | Heather M Strickling | Nurse Anesthetist, Certified Registered | 799 Lexington Ave, Mansfield, OH 44907-1906 | 2013-07-31 |
| 1982042487 | Brasier Anesthesia, Pllc | Nurse Anesthetist, Certified Registered | 7364 Hinton Dr, Mansfield, TX 76063-4639 | 2013-06-06 |
| 1962707323 | Emile G Abouhassan | Nurse Anesthetist, Certified Registered | 799 Lexington Ave, Mansfield, OH 44907-1906 | 2011-01-17 |
| 1134424591 | Bethany A Biddle | Nurse Anesthetist, Certified Registered | 799 Lexington Ave, Mansfield, OH 44907-1906 | 2011-01-17 |
| 1871739581 | Darren Rodney Long | Nurse Anesthetist, Certified Registered | 799 Lexington Ave, Mansfield, OH 44907-1906 | 2008-12-30 |
| Find all providers in MANSFIELD | ||||
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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.