Provider Demographics
NPI:1578746343
Name:INVASIVE PAIN MANAGEMENT SOLUTIONS,P.A.
Entity Type:Organization
Organization Name:INVASIVE PAIN MANAGEMENT SOLUTIONS,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT
Authorized Official - Prefix:DR
Authorized Official - First Name:ENYIBUAKU
Authorized Official - Middle Name:RITA
Authorized Official - Last Name:UZOAGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-446-4053
Mailing Address - Street 1:18929 HIGHWAY 59 N
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-4270
Mailing Address - Country:US
Mailing Address - Phone:281-446-4053
Mailing Address - Fax:
Practice Address - Street 1:18929 HIGHWAY 59 N
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4270
Practice Address - Country:US
Practice Address - Phone:281-446-4053
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-14
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0297207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXI26811Medicare UPIN
TX611637Medicare PIN