Healthcare Provider Details

I. General information

NPI: 1508824186
Provider Name (Legal Business Name): THE PAIN CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2327 W HIGHWAY 35
ANGLETON TX
77515-7455
US

IV. Provider business mailing address

PO BOX 25403
HOUSTON TX
77265-5403
US

V. Phone/Fax

Practice location:
  • Phone: 979-848-1886
  • Fax: 979-848-1376
Mailing address:
  • Phone: 713-574-9922
  • Fax: 713-456-2220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number37976
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberH9633
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1127272
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number101757
License Number StateTX

VIII. Authorized Official

Name: MELISSA STEWART
Title or Position: CREDENTIALING COORDINATOR
Credential:
Phone: 713-574-9922