Legacy Interventional Pain Center, LLC

NPI #1649685892 in Addison, Texas

Provider Information

NPI Number: 1649685892
Entity Type: Organization
Organization Name: Legacy Interventional Pain Center, LLC
Primary Specialty: Registered Nurse
Enumeration Date: Jun 26, 2014
Last Updated: Jun 26, 2014

Practice Location

Address: 17051 DALLAS PKWY
Address 2: STE 100
City: Addison
State: Texas
ZIP Code: 75001-7109
Phone: (469) 916-0521

Authorized Official

Name: TRACY WALLS
Title: MANAGER
Phone: (972) 234-4740

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Registered Nurse	163W00000X	Primary

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