Provider Demographics
NPI:1972002038
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:S
Authorized Official - Last Name:BARTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-480-4740
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:281-991-3022
Practice Address - Street 1:251 W MEDICAL CENTER BLVD STE 230
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4242
Practice Address - Country:US
Practice Address - Phone:832-844-5154
Practice Address - Fax:281-751-6407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-05
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9353208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX635241OtherMEDICARE