Provider Demographics
NPI:1255853693
Name:BACK PAIN AND SCIATICA CENTER OF TEXAS, PLLC
Entity Type:Organization
Organization Name:BACK PAIN AND SCIATICA CENTER OF TEXAS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:K
Authorized Official - Last Name:EULITT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:936-494-1222
Mailing Address - Street 1:2510 S LOOP 336 W
Mailing Address - Street 2:SUITE 245
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304
Mailing Address - Country:US
Mailing Address - Phone:936-494-1222
Mailing Address - Fax:936-494-1245
Practice Address - Street 1:2510 S LOOP 336 W
Practice Address - Street 2:SUITE 245
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304
Practice Address - Country:US
Practice Address - Phone:936-494-1222
Practice Address - Fax:936-494-1245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-07
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty