Provider Demographics
NPI:1760998108
Name:TEXAS PAIN AND REGENERATIVE MEDICINE PLLC
Entity Type:Organization
Organization Name:TEXAS PAIN AND REGENERATIVE MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SAMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:FAHED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-993-7072
Mailing Address - Street 1:11226 SOUTHWEST FWY STE A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77031-3604
Mailing Address - Country:US
Mailing Address - Phone:832-486-9346
Mailing Address - Fax:832-553-7823
Practice Address - Street 1:11226 SOUTHWEST FWY STE A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77031-3604
Practice Address - Country:US
Practice Address - Phone:832-486-9346
Practice Address - Fax:832-553-7823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-21
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty