Provider Demographics
NPI:1194308601
Name:DALLAS PAIN INSTITUTE
Entity type:Organization
Organization Name:DALLAS PAIN INSTITUTE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SREENADHA
Authorized Official - Middle Name:
Authorized Official - Last Name:VATTAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-426-2500
Mailing Address - Street 1:1001 SARA SWAMY DR
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-3120
Mailing Address - Country:US
Mailing Address - Phone:903-892-1999
Mailing Address - Fax:903-892-6999
Practice Address - Street 1:7700 LAKEVIEW PKWY # 100B
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75088-4362
Practice Address - Country:US
Practice Address - Phone:469-653-0222
Practice Address - Fax:903-892-6999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-03
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPainGroup - Single Specialty