PREMIERE PAIN SPECIALISTS LLC (NPI# 1013472265) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013472265 |
| Entity Type | Organization |
| Organization Name | PREMIERE PAIN SPECIALISTS LLC |
| Practice Address |
12309 N Mopac Expy Ste 125 Austin TX 78758-2577 |
| Practice Telephone | 5122068000 |
| Mailing Telephone | 5122068000 |
| Enumeration Date | 2019-02-01 |
| Last Update Date | 2020-03-08 |
| Authorized Official Name | KRISTYN BILLINGS (INSURANCE DEPT) |
| Authorized Official Telephone | 4126554362 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | STATE LICENSE | M3402 | 01 |
| Street Address |
12309 N MOPAC EXPY STE 125 |
| City | AUSTIN |
| State | TX |
| Zip Code | 78758-2577 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134761935 | Central Texas Anesthesia Partners Pllc | Anesthesiology | 12309 N Mopac Expy Ste 125, Austin, TX 78758-2577 | 2019-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225644065 | Seton Family of Doctors | Internal Medicine | 3001 Palm Way, D1 : 134-138, Austin, TX 78758 | 2020-09-17 |
| 1083243661 | Donna Bella Laurel Portillo | Pharmacist | 12221 N Mopac Expwy, Austin, TX 78758 | 2020-04-05 |
| 1881249092 | Elizabeth Logan Anderson | Behavioral Analyst | 2100 Kramer Ln., Suite 150, Austin, TX 78758 | 2019-08-05 |
| 1295388502 | Bridget Sue Morgan | Behavioral Analyst | 2100 Kramer Ln #150, Austin, TX 78758 | 2019-07-17 |
| 1508326885 | Jonathan James Runnels | Anesthesiologist Assistant | 12221n Mopac, Austin, TX 78758 | 2019-03-22 |
| 1427527324 | Nayely Gutierrez | Dietitian, Registered | 8606 Delaware Ct, Austin, TX 78758 | 2018-11-20 |
| 1720569635 | Shari Wright | Licensed Vocational Nurse | 12349 Metric Blvs # 425, Austin, TX 78758 | 2018-08-28 |
| 1528545456 | Alexis N Bongiorno | Registered Nurse | 11901 Hobby Horse Court, 1516, Austin, TX 78758 | 2018-07-24 |
| 1679072573 | Lori Scott | Counselor | 1600 Payton Gin Road, Austin, TX 78758 | 2018-02-06 |
| 1003322488 | Lisa Robyn Lee | Behavior Technician | 2018 W Rundberg Ln, #13d, Austin, TX 78758 | 2017-12-20 |
| Find all providers in zip 78758 | ||||
| Taxonomy Code | 208VP0014X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Interventional Pain Medicine |
| Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871970871 | Gregory Nicholas Yanez | Pain Medicine | 4316 James Casey St Building B Suite 200, Austin, TX 78745 | 2015-04-29 |
| 1578567459 | Integrative Pain Services Pa | Pain Medicine | 4807 Spicewood Springs Rd, Ste 1235, Austin, TX 78759-8478 | 2005-06-09 |
| 1487196614 | Alan D Silberberg, Md Pa | Pain Medicine | 5625 Eiger Rd, Suite 160, Austin, TX 78735-8977 | 2016-11-04 |
| 1235514704 | Central Texas Pain Center North, Pllc | Pain Medicine | 4316 James Casey St, Bldg B, Suite 200, Austin, TX 78745-1116 | 2015-07-27 |
| 1821484031 | Jamal Hasoon | Pain Medicine | 4316 James Casey St Ste 200, Austin, TX 78745-1116 | 2015-04-14 |
| 1295130912 | Central Texas Pain Center, Pllc | Pain Medicine | 4316 James Casey St, Bldg B, Suite 200, Austin, TX 78745-1116 | 2014-10-23 |
| 1184987174 | Rahul Sarna | Pain Medicine | 4100 Duval Rd, Bldg IIi Ste 200, Austin, TX 78759 | 2012-06-25 |
| 1336416510 | Robert P Wills Md Pllc | Pain Medicine | 2200 Park Bend Dr, Bldg 1, Suite 201, Austin, TX 78758-5387 | 2011-11-16 |
| 1306124912 | Derrick Wansom | Pain Medicine | 4100 Duval Rd, Bldg 3 Ste 200, Austin, TX 78759-4275 | 2011-07-31 |
| 1053526343 | Pain Management Consultants, Pa | Pain Medicine | 101 W Koenig Ln, Ste 100, Austin, TX 78751-1213 | 2007-05-11 |
| Find all providers in AUSTIN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.