Provider Demographics
NPI:1649510215
Name:SOUTH TEXAS PAIN SPECIALISTS, PA
Entity type:Organization
Organization Name:SOUTH TEXAS PAIN SPECIALISTS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SHYAM
Authorized Official - Middle Name:
Authorized Official - Last Name:PURSWANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-236-5558
Mailing Address - Street 1:2455 NE LOOP 410
Mailing Address - Street 2:SUITE 249
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-5649
Mailing Address - Country:US
Mailing Address - Phone:210-236-5558
Mailing Address - Fax:210-236-7251
Practice Address - Street 1:2455 NE LOOP 410
Practice Address - Street 2:SUITE 249
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-5649
Practice Address - Country:US
Practice Address - Phone:210-236-5558
Practice Address - Fax:210-236-7251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-19
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK10052081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty