Provider Demographics
NPI:1316244205
Name:INCLUSIVE PAIN MANAGEMENT SPECIALISTS PLLC
Entity type:Organization
Organization Name:INCLUSIVE PAIN MANAGEMENT SPECIALISTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:ABBATE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:713-900-7246
Mailing Address - Street 1:630 N BISHOP AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-4335
Mailing Address - Country:US
Mailing Address - Phone:214-942-5673
Mailing Address - Fax:
Practice Address - Street 1:630 N BISHOP AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-4335
Practice Address - Country:US
Practice Address - Phone:214-942-5673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-11
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN4873261QH0100X, 208VP0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty