Provider Demographics
NPI:1588153795
Name:CENTAURUS PAIN, LLC
Entity type:Organization
Organization Name:CENTAURUS PAIN, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:
Authorized Official - Last Name:GOMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-238-1067
Mailing Address - Street 1:660 SW MILITARY DR STE E
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78221-1671
Mailing Address - Country:US
Mailing Address - Phone:210-617-3172
Mailing Address - Fax:210-455-9306
Practice Address - Street 1:660 SW MILITARY DR STE E
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78221-1671
Practice Address - Country:US
Practice Address - Phone:210-617-3172
Practice Address - Fax:210-455-9306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-02
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty