Provider Demographics
NPI:1699417063
Name:LEAGUE CITY PAIN AND WLLNESS, PLLC
Entity Type:Organization
Organization Name:LEAGUE CITY PAIN AND WLLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:MURATTA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:256-504-5232
Mailing Address - Street 1:3033 MARINA BAY DR STE 120
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-3982
Mailing Address - Country:US
Mailing Address - Phone:281-549-6686
Mailing Address - Fax:877-782-0224
Practice Address - Street 1:3033 MARINA BAY DR STE 120
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-3982
Practice Address - Country:US
Practice Address - Phone:281-549-6686
Practice Address - Fax:877-782-0224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty