Provider Demographics
NPI:1962587451
Name:TEXAS PAIN AND INJURY
Entity type:Organization
Organization Name:TEXAS PAIN AND INJURY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTOPHER
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-427-4878
Mailing Address - Street 1:PO BOX 55236
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054-5236
Mailing Address - Country:US
Mailing Address - Phone:817-427-4878
Mailing Address - Fax:
Practice Address - Street 1:8208 BEDFORD EULESS RD
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-7214
Practice Address - Country:US
Practice Address - Phone:817-427-4878
Practice Address - Fax:817-427-4884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8074111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX606080OtherBLUECROSS AND BLUE SHIELD
U78212Medicare UPIN
TX606080OtherBLUECROSS AND BLUE SHIELD