IMED PHYSICIAN NETWORK, INC. – Interventional Pain Medicine Physician, NPI 1063809465
Interventional Pain Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for IMED PHYSICIAN NETWORK, INC.
PO BOX 2668
DESOTO, TX 751232668
Phone: (972) 865-4454
Fax: (214) 888-4450
Type: Mailing
1395 E Eldorado Pkwy Ste 600
Little Elm, TX 750685533
Phone: (972) 865-4454
Type: Location
4211 Cedar Springs Rd Ste 200
Dallas, TX 752192600
Phone: (972) 865-4454
Type: Location
222 W Harrison Ave Ste C
Harlingen, TX 785506484
Phone: (972) 865-4454
Type: Location
25311 Kingsland Blvd Ste 190
Katy, TX 774947349
Phone: (972) 865-4454
Type: Location
221 Regency Pkwy Ste 105
Mansfield, TX 760635379
Phone: (972) 865-4454
Type: Location
1401 Jane Ln
West, TX 766911013
Phone: (972) 865-4454
Type: Location
13988 Diplomat Dr Ste 100C
Farmers Branch, TX 752348807
Phone: (972) 865-4454
Type: Location
117 Jane Ln
Hillsboro, TX 766452673
Phone: (972) 865-4454
Type: Location
6044 Gateway Blvd E
El Paso, TX 799052023
Phone: (972) 865-4454
Type: Location
1300 3rd St
Corpus Christi, TX 784042208
Phone: (972) 865-4454
Type: Location
5108 McPherson Rd Ste 101-B
Laredo, TX 780417321
Phone: (972) 865-4454
Type: Location
2600 Old Alice Rd
Brownsville, TX 785211594
Phone: (972) 865-4454
Type: Location
5055 W Park Blvd
Plano, TX 750932586
Phone: (972) 865-4454
Type: Location
1401 E Ridge Rd Ste B1
McAllen, TX 785031524
Phone: (972) 865-4454
Type: Location
2700 W PLEASANT RUN RD STE 340
LANCASTER, TX 751461074
Phone: (972) 865-4454
Fax: (214) 888-4450
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-08-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-08-31 (645 days ago).
Enrollment records
1
Earliest due date
2024-08-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20190807001189 | O | Clinic/Group Practice | TX | 2024-08-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 75123)
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