Provider Demographics
NPI:1245484856
Name:ACUTE & CHRONIC PAIN MANGEMENT
Entity type:Organization
Organization Name:ACUTE & CHRONIC PAIN MANGEMENT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BECKY
Authorized Official - Middle Name:
Authorized Official - Last Name:MORA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-353-6100
Mailing Address - Street 1:24 CARE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79124
Mailing Address - Country:US
Mailing Address - Phone:806-353-6100
Mailing Address - Fax:806-353-3372
Practice Address - Street 1:24 CARE CIR
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79124-2118
Practice Address - Country:US
Practice Address - Phone:806-353-6100
Practice Address - Fax:806-353-3372
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACUTE & CHRONIC PAIN MGMT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-11-10
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH7403208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty