Brain & Pain Care, LLC
in Shreveport, LA. Organization (NPI-2).
NPI number1760025001
StatusActive
Last updated in NPPESSep 3, 2021
Details
- NPI
- 1760025001
- Entity type
- Organization (NPI-2)
- Legal business name
- Brain & Pain Care, LLC
- Organization subpart
- No
- Enumeration date
- Oct 18, 2019
- Certification date
- Sep 3, 2021
- Last updated
- Sep 3, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208VP0000X | – | – | Yes |
Practice location
7600 Fern Ave Ste 700bShreveport, LA 71105-5673
Phone 318-616-6000 · Fax 318-616-6616
Mailing address
8020 Captain Dillon CtShreveport, LA 71115-4606
Phone 318-469-8517
Authorized official
Jai Munjampalli
Owner
3184698517
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