| NPI | 1770944076 |
|---|---|
| Former Legal Business Name | CENTRAL TEXAS PAIN CENTER - FORT WORTH, P.A. |
| Entity Type | Organization |
| Authorized Contact | ERIC JAMES MILLER Owner 817-667-9535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: TX Q6623) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX Q6623) |
| Enumeration Date | 2016-03-14 |
| Last Update Date | 2018-03-21 |