Provider Demographics
NPI:1902979685
Name:ALLIANCE PAIN CENTERS, PC
Entity Type:Organization
Organization Name:ALLIANCE PAIN CENTERS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JADE
Authorized Official - Middle Name:
Authorized Official - Last Name:MALAY
Authorized Official - Suffix:
Authorized Official - Credentials:DC, DABCO
Authorized Official - Phone:972-378-0383
Mailing Address - Street 1:2800 N DALLAS PKWY
Mailing Address - Street 2:SUITE 150
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5993
Mailing Address - Country:US
Mailing Address - Phone:972-378-0383
Mailing Address - Fax:972-492-2074
Practice Address - Street 1:2800 N DALLAS PKWY
Practice Address - Street 2:SUITE 150
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5993
Practice Address - Country:US
Practice Address - Phone:972-378-0383
Practice Address - Fax:972-403-3434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC6310111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX83Z420OtherBCBS IDENTIFIER
TXU61021OtherUPIN
TX6252820001Medicare NSC
TXU61021OtherUPIN