Provider Demographics
NPI:1699468546
Name:TEXAS SPINE & PAIN MD PLLC
Entity type:Organization
Organization Name:TEXAS SPINE & PAIN MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PRAVEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:NATAKAL PAKEERAPPA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-401-5145
Mailing Address - Street 1:PO BOX 429
Mailing Address - Street 2:
Mailing Address - City:BONHAM
Mailing Address - State:TX
Mailing Address - Zip Code:75418-0429
Mailing Address - Country:US
Mailing Address - Phone:903-401-5145
Mailing Address - Fax:903-401-5146
Practice Address - Street 1:1055 CLARKSVILLE ST STE 165
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-0211
Practice Address - Country:US
Practice Address - Phone:903-401-5145
Practice Address - Fax:903-401-5146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-26
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty