Provider Demographics
NPI:1902396161
Name:GALLERIA PAIN PHYSICIANS PLLC
Entity Type:Organization
Organization Name:GALLERIA PAIN PHYSICIANS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:210-885-6752
Mailing Address - Street 1:PO BOX 690572
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77269-0572
Mailing Address - Country:US
Mailing Address - Phone:281-480-4740
Mailing Address - Fax:
Practice Address - Street 1:6700 WEST LOOP S STE 225
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-4104
Practice Address - Country:US
Practice Address - Phone:281-480-4740
Practice Address - Fax:281-205-3502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-14
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00Q26JOtherBCBS