| NPI | 1063643633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GORDON A BEARDWOOD Owner 210-824-5292 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine | |
| Enumeration Date | 2009-07-30 |
| Last Update Date | 2010-02-19 |