Healthcare Provider Details

I. General information

NPI: 1710501275
Provider Name (Legal Business Name): PAIN AND HEADACHE CENTERS OF TEXAS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2020
Last Update Date: 06/01/2020
Certification Date: 06/01/2020
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

3811 RUSKIN ST
HOUSTON TX
77005-4330
US

V. Phone/Fax

Practice location:
  • Phone: 832-831-7800
  • Fax: 832-831-7801
Mailing address:
  • Phone: 972-365-5434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: PANKAJ SATIJA
Title or Position: PHYSICIAN
Credential: MD
Phone: 832-831-7800