Organization · NPI-2

360 Pain And Spine PLLC

Anesthesiology, Pain Medicine · Richardson, TX

NPI number1821611153

StatusActive

Last updated in NPPESAug 18, 2022

Details

NPI: 1821611153
Entity type: Organization (NPI-2)
Legal business name: 360 Pain And Spine PLLC
Organization subpart: No
Enumeration date: May 21, 2020
Certification date: Aug 18, 2022
Last updated: Aug 18, 2022

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207LP2900X	Anesthesiology, Pain Medicine	–	–	Yes
207L00000X	Anesthesiology	–	–
208VP0014X	Pain Medicine, Interventional Pain Medicine	–	–
2084N0400X	Psychiatry & Neurology, Neurology	–	–

Other names

Renner Pain And Spine (Doing Business As)

Practice location

3009 E Renner Rd Ste 100
Richardson, TX 75082-3572

Phone 469-589-1871 · Fax 469-589-1872

Mailing address

3009 E Renner Rd Ste 100
Richardson, TX 75082-3572

Phone 469-589-1871 · Fax 469-589-1872

Authorized official

Obaid Malik
Director
4695891871

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.