| NPI | 1093697641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTICE OTCHERE Medical Director 682-433-9287 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 225100000X Physical Therapist | |
| 208100000X Physical Medicine & Rehabilitation | |
| 261QP3300X Clinic/Center, Pain | |
| 207LP2900X Anesthesiology, Pain Medicine | |
| Enumeration Date | 2025-07-24 |
| Last Update Date | 2026-06-12 |