Advanced Pain And Headache Medical Clinic
Preferred Provider Organization in Houston, TX. Organization (NPI-2).
NPI number1659805976
StatusActive
Last updated in NPPESApr 13, 2017
Details
- NPI
- 1659805976
- Entity type
- Organization (NPI-2)
- Legal business name
- Advanced Pain And Headache Medical Clinic
- Organization subpart
- No
- Enumeration date
- Apr 13, 2017
- Last updated
- Apr 13, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 305R00000X | Preferred Provider Organization | – | – | Yes |
| 302F00000X | Exclusive Provider Organization | – | – |
Practice location
4151 Southwest Fwy Ste 720Houston, TX 77027-7308
Phone 713-530-0003
Mailing address
Po Box 980101Houston, TX 77254
Authorized official
Ibett Robles
Manager
7135300003
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