Provider Demographics
NPI:1467646364
Name:HOLISTIC HOUSTON PAIN CENTER,PA
Entity Type:Organization
Organization Name:HOLISTIC HOUSTON PAIN CENTER,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAVI
Authorized Official - Middle Name:VENKATESWARLU
Authorized Official - Last Name:TAMERISA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-277-3300
Mailing Address - Street 1:3519 TOWN CENTER BLVD S
Mailing Address - Street 2:SUITE B
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-1000
Mailing Address - Country:US
Mailing Address - Phone:281-277-3300
Mailing Address - Fax:
Practice Address - Street 1:3519 TOWN CENTER BLVD S
Practice Address - Street 2:SUITE B
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-1000
Practice Address - Country:US
Practice Address - Phone:281-277-3300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF5443207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty