Provider Demographics
NPI:1891030169
Name:ADVANCED INVASIVE PAIN MANAGEMENT OF HOUSTON
Entity Type:Organization
Organization Name:ADVANCED INVASIVE PAIN MANAGEMENT OF HOUSTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:BALLARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-487-7709
Mailing Address - Street 1:308 W PARKWOOD AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-5478
Mailing Address - Country:US
Mailing Address - Phone:713-943-7246
Mailing Address - Fax:713-943-9480
Practice Address - Street 1:3558 E 51ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-3518
Practice Address - Country:US
Practice Address - Phone:713-943-7246
Practice Address - Fax:713-943-9480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-28
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty