Provider Demographics
NPI:1134562804
Name:HOUSTON PAIN CENTER-MEMORIAL, LLC
Entity type:Organization
Organization Name:HOUSTON PAIN CENTER-MEMORIAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:ADRIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLARREAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-295-6703
Mailing Address - Street 1:7700 MAIN ST STE 400
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4456
Mailing Address - Country:US
Mailing Address - Phone:214-295-6703
Mailing Address - Fax:
Practice Address - Street 1:7700 MAIN ST STE 400
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4456
Practice Address - Country:US
Practice Address - Phone:214-295-6703
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-12
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical