Healthcare Provider Details

I. General information

NPI: 1801267661
Provider Name (Legal Business Name): INNOVATIVE PAIN AND SPINE INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2015
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21820 KINGSLAND BLVD STE 101A
KATY TX
77450-2507
US

IV. Provider business mailing address

9654 KATY FWY STE C200
HOUSTON TX
77055-6341
US

V. Phone/Fax

Practice location:
  • Phone: 713-714-7834
  • Fax: 888-202-1057
Mailing address:
  • Phone: 713-714-7834
  • Fax: 888-202-1057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSEPH AMOS
Title or Position: SOLE PROPRIETOR
Credential: M.D.
Phone: 214-293-9067