Provider Demographics
NPI:1952993560
Name:MODERN PAIN MANAGEMENT PLLC
Entity Type:Organization
Organization Name:MODERN PAIN MANAGEMENT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:MICHEL
Authorized Official - Last Name:ATALLAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-298-0120
Mailing Address - Street 1:902 FROSTWOOD DR STE 235
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2417
Mailing Address - Country:US
Mailing Address - Phone:713-298-0120
Mailing Address - Fax:
Practice Address - Street 1:12930 DAIRY ASHFORD RD STE 501
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4667
Practice Address - Country:US
Practice Address - Phone:713-298-0120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MODERN PAIN MANAGEMENT, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-04
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty