Organization · NPI-2

Centex Pain & Physical Medicine, LLC

Clinic/Center · Waco, TX

NPI number1548011968
StatusActive
Last updated in NPPESApr 1, 2024

Details

NPI
1548011968
Entity type
Organization (NPI-2)
Legal business name
Centex Pain & Physical Medicine, LLC
Organization subpart
No
Enumeration date
Apr 1, 2024
Certification date
Apr 1, 2024
Last updated
Apr 1, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center––Yes

Other names

  • Centex Spine And Rehab, LLC (Doing Business As)

Practice location

2020 N Valley Mills Dr
Waco, TX 76710-2561

Phone 254-405-4429

Mailing address

2020 N Valley Mills Dr
Waco, TX 76710-2561

Phone 254-405-4429

Authorized official

Shawn Fyke
President
2546443389

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