Healthcare Provider Details

I. General information

NPI: 1366830614
Provider Name (Legal Business Name): HOUSTON SPINE & JOINT PAIN CONSULTANTS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2015
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4101 GREENBRIAR DR # 208
HOUSTON TX
77098-5294
US

IV. Provider business mailing address

4101 GREENBRIAR DR # 208
HOUSTON TX
77098-5294
US

V. Phone/Fax

Practice location:
  • Phone: 832-538-1024
  • Fax: 832-538-1023
Mailing address:
  • Phone: 832-777-7246
  • Fax: 832-706-7777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SHABREZ TARIQ
Title or Position: MD
Credential:
Phone: 832-777-7246