Provider Demographics
NPI:1013366335
Name:TMC PAIN SURGICAL CENTER
Entity Type:Organization
Organization Name:TMC PAIN SURGICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:PAPPOLLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:713-661-0300
Mailing Address - Street 1:2646 S LOOP W
Mailing Address - Street 2:SUITE 140
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2665
Mailing Address - Country:US
Mailing Address - Phone:713-661-0300
Mailing Address - Fax:281-822-0480
Practice Address - Street 1:2646 S LOOP W
Practice Address - Street 2:SUITE 140
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2665
Practice Address - Country:US
Practice Address - Phone:713-661-0300
Practice Address - Fax:281-822-0480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5436261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain