Provider Demographics
NPI:1720258353
Name:ALTERNATIVE PAIN CARE INSTITUTE, LLP
Entity type:Organization
Organization Name:ALTERNATIVE PAIN CARE INSTITUTE, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:VALENTIN
Authorized Official - Middle Name:PETKOV
Authorized Official - Last Name:VALTCHANOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:682-433-8072
Mailing Address - Street 1:PO BOX 1067
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76039-1067
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5833 SPOHN DR
Practice Address - Street 2:SUITE 401
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-4135
Practice Address - Country:US
Practice Address - Phone:361-992-9432
Practice Address - Fax:361-992-3978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD5354261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
Provider Identifiers
StateIdentifier IDID TypeIssuer
611649100OtherDOL FECA