Provider Demographics
NPI:1629048582
Name:MAINLAND ANESTHESIA ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:MAINLAND ANESTHESIA ASSOCIATES, P.A.
Other - Org Name:MAINLAND PAIN CONSULTANTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRISON
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:PINCHOT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-534-1133
Mailing Address - Street 1:PO BOX 3945
Mailing Address - Street 2:DEPT 576
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77253-3945
Mailing Address - Country:US
Mailing Address - Phone:713-510-8522
Mailing Address - Fax:949-862-2868
Practice Address - Street 1:3750 MEDICAL PARK DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:DICKINSON
Practice Address - State:TX
Practice Address - Zip Code:77539
Practice Address - Country:US
Practice Address - Phone:281-534-1133
Practice Address - Fax:281-534-2190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-24
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH7207207L00000X, 207LP2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00L20GOtherBLUE CROSS/BLUE SHIELD
TX083667801Medicaid
TXCC8952OtherRAILROAD MEDICARE
TX00C30NOtherBLUE CROSS/BLUE SHIELD
TX090123301Medicaid
TX00L20GMedicare PIN
TX00L20GOtherBLUE CROSS/BLUE SHIELD