Provider Demographics
NPI:1619154770
Name:WEST HOUSTON PAIN SERVICES PA
Entity Type:Organization
Organization Name:WEST HOUSTON PAIN SERVICES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DUMITRU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-461-8555
Mailing Address - Street 1:9055 KATY FWY STE 311
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1630
Mailing Address - Country:US
Mailing Address - Phone:713-461-8555
Mailing Address - Fax:
Practice Address - Street 1:9180 KATY FWY STE 202
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-7443
Practice Address - Country:US
Practice Address - Phone:713-647-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical