Provider Demographics
NPI:1659397628
Name:TEXAS NEUROLOGICAL & PAIN INSTITUTE
Entity Type:Organization
Organization Name:TEXAS NEUROLOGICAL & PAIN INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:254-776-9775
Mailing Address - Street 1:205 WOODHEW DR
Mailing Address - Street 2:STE 200
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712
Mailing Address - Country:US
Mailing Address - Phone:254-776-9775
Mailing Address - Fax:254-776-9751
Practice Address - Street 1:205 WOODHEW DR
Practice Address - Street 2:STE 200
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712
Practice Address - Country:US
Practice Address - Phone:254-776-9775
Practice Address - Fax:254-776-9751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1462207T00000X
TX03202006-10012006208VP0014X
TX05112006-10012006208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
Not Answered208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0020NROtherBLUE CROSS BLUE SHIELD ID