Healthcare Provider Details

I. General information

NPI: 1013803147
Provider Name (Legal Business Name): PERFORMANCE PAIN AND SPORTS MEDICINE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2025
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 W BAKER RD STE A
BAYTOWN TX
77521-2284
US

IV. Provider business mailing address

PO BOX 649834
DALLAS TX
75264-9834
US

V. Phone/Fax

Practice location:
  • Phone: 346-217-1111
  • Fax: 346-571-2189
Mailing address:
  • Phone: 346-308-6741
  • Fax: 346-571-2189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: HEATHER ROSE FEILER
Title or Position: LEAD FINANCIAL REPRESENTATIVE
Credential: CPC
Phone: 346-308-6741