Professional Pain Consult
Clinic/Center in Southlake, TX. Organization (NPI-2).
NPI number1730765652
StatusActive
Last updated in NPPESJul 1, 2024
Details
- NPI
- 1730765652
- Entity type
- Organization (NPI-2)
- Legal business name
- Professional Pain Consult
- Organization subpart
- No
- Enumeration date
- Mar 22, 2021
- Certification date
- Jul 1, 2024
- Last updated
- Jul 1, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
Practice location
470 E State Highway 114Southlake, TX 76092-4406
Phone 214-450-9926 · Fax 972-432-6692
Mailing address
5995 Summerside Dr Unit 798002Dallas, TX 75379-0222
Phone 214-390-7697 · Fax 972-432-6692
Authorized official
Moshe Feldhendler
Owner
2145005755
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