Provider Demographics
NPI:1295109213
Name:INNOVATIVE PAIN CONSULTANTS LLP
Entity type:Organization
Organization Name:INNOVATIVE PAIN CONSULTANTS LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:CAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-487-0890
Mailing Address - Street 1:11524 SPACE CENTER BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77059-3603
Mailing Address - Country:US
Mailing Address - Phone:281-487-0890
Mailing Address - Fax:888-507-8586
Practice Address - Street 1:11524 SPACE CENTER BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77059-3603
Practice Address - Country:US
Practice Address - Phone:281-487-0890
Practice Address - Fax:888-507-8586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-16
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain