Serenity Acute Headache Center PLLC
Pain Medicine, Interventional Pain Medicine in Plano, TX. Organization (NPI-2).
NPI number1619794328
StatusActive
Last updated in NPPESSep 24, 2024
Details
- NPI
- 1619794328
- Entity type
- Organization (NPI-2)
- Legal business name
- Serenity Acute Headache Center PLLC
- Organization subpart
- No
- Enumeration date
- Sep 24, 2024
- Certification date
- Sep 24, 2024
- Last updated
- Sep 24, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208VP0014X | Pain Medicine, Interventional Pain Medicine | – | – | Yes |
| 207LP2900X | Anesthesiology, Pain Medicine | – | – | |
| 261QP3300X | Clinic/Center, Pain | – | – |
Practice location
6101 W Plano Pkwy Ste 200Plano, TX 75093-8373
Phone 404-354-0153
Mailing address
4145 Belt Line Rd Ste 212-237Addison, TX 75001-4324
Phone 404-354-0153
Authorized official
Anthony Thaddeus Clavo
Medical Director
4043540153
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