Healthcare Provider Details

I. General information

NPI: 1336542513
Provider Name (Legal Business Name): PAIN AND HEADACHE CENTERS OF TEXAS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2014
Last Update Date: 11/27/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1313 LA CONCHA LN STE 120
HOUSTON TX
77054-1809
US

IV. Provider business mailing address

1313 LA CONCHA LN STE 120
HOUSTON TX
77054-1809
US

V. Phone/Fax

Practice location:
  • Phone: 832-831-7800
  • Fax: 832-831-7801
Mailing address:
  • Phone: 832-831-7800
  • Fax: 832-831-7801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberN0437
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code2084P0301X
TaxonomyBrain Injury Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberN0437
License Number StateTX
# 8
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 9
Primary TaxonomyN
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State
# 10
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberN0437
License Number StateTX

VIII. Authorized Official

Name: DR. PANKAJ SATIJA
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 972-365-5434