Provider Demographics
NPI:1295923522
Name:PRECISION PAIN CARE, LLC
Entity type:Organization
Organization Name:PRECISION PAIN CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:281-658-6861
Mailing Address - Street 1:5380 W 34TH ST
Mailing Address - Street 2:NO. 164
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77092-6626
Mailing Address - Country:US
Mailing Address - Phone:281-658-6861
Mailing Address - Fax:
Practice Address - Street 1:5380 W 34TH ST
Practice Address - Street 2:NO. 164
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-6626
Practice Address - Country:US
Practice Address - Phone:281-658-6861
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1148030261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy