Healthcare Provider Details

I. General information

NPI: 1316307275
Provider Name (Legal Business Name): PERFORMANCE PAIN AND SPORTS MEDICINE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2016
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4126 SOUTHWEST FWY STE 1700
HOUSTON TX
77027-7317
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 Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: SUZANNE MANZI
Title or Position: OWNER
Credential: MD
Phone: 346-308-6741