Provider Demographics
NPI:1841463585
Name:BACK PAIN INTERVENTIONS ASSOCIATED, P.A.
Entity type:Organization
Organization Name:BACK PAIN INTERVENTIONS ASSOCIATED, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:281-494-6900
Mailing Address - Street 1:1111 HIGHWAY 6 STE 122
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4900
Mailing Address - Country:US
Mailing Address - Phone:281-494-6900
Mailing Address - Fax:832-532-7782
Practice Address - Street 1:1111 HIGHWAY 6 STE 122
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4900
Practice Address - Country:US
Practice Address - Phone:281-494-6900
Practice Address - Fax:832-532-7782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-02
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG7042208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122445307Medicaid