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Contact Information

AVENSTAR PAIN SPECIALISTS, PLLC
1732 S SOONER RD
MIDWEST CITY, OK73110
 Phone: 405-438-0913
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Interventional Pain Medicine

208VP0014X 09 Physician/Interventional Pain Management
 

Family Medicine - Sports Medicine

207QS0010X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for AVENSTAR PAIN SPECIALISTS, PLLC

NPI Number 1104219385
LBN Legal business name AVENSTAR PAIN SPECIALISTS, PLLC
Authorized official STEVE RANDALL - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 03/11/2015
Last updated 03/06/2025 - More than a year ago
Identifiers
OK License # 2493
TX License # N4691
OK Medicaid 200341890A
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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