Provider Demographics
NPI:1912279001
Name:THE PAIN CARE CENTER INC.
Entity Type:Organization
Organization Name:THE PAIN CARE CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MBA
Authorized Official - Phone:713-826-1336
Mailing Address - Street 1:PO BOX 25403
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77265-5403
Mailing Address - Country:US
Mailing Address - Phone:713-724-0087
Mailing Address - Fax:
Practice Address - Street 1:5555 WEST LOOP S STE 210
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2106
Practice Address - Country:US
Practice Address - Phone:713-724-0087
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-03
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0828808Medicaid
TX00H13EMedicare PIN