Provider Demographics
NPI:1578379517
Name:VILLA PAIN INSTITUTE PLLC
Entity type:Organization
Organization Name:VILLA PAIN INSTITUTE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROSEMARY
Authorized Official - Middle Name:
Authorized Official - Last Name:DE LA CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-701-1754
Mailing Address - Street 1:6955 N MESA ST STE 200
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-4442
Mailing Address - Country:US
Mailing Address - Phone:833-339-7246
Mailing Address - Fax:915-257-6302
Practice Address - Street 1:1351 N ZARAGOZA RD BLDG R
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-7902
Practice Address - Country:US
Practice Address - Phone:833-339-7246
Practice Address - Fax:915-257-6302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty