Provider Demographics
NPI:1134727233
Name:TERRA PAIN CONSULTANTS PLLC
Entity type:Organization
Organization Name:TERRA PAIN CONSULTANTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:UTPAL
Authorized Official - Middle Name:K
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-561-9727
Mailing Address - Street 1:PO BOX 12169
Mailing Address - Street 2:
Mailing Address - City:RTP
Mailing Address - State:NC
Mailing Address - Zip Code:27709-2169
Mailing Address - Country:US
Mailing Address - Phone:919-544-6318
Mailing Address - Fax:
Practice Address - Street 1:812 CANDY PARK RD STE 6103
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:NC
Practice Address - Zip Code:28372-9121
Practice Address - Country:US
Practice Address - Phone:910-561-9727
Practice Address - Fax:866-950-0218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-12
Last Update Date:2021-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty