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General NPI Number Information
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NPI Number | 1104187061
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Entity Type | Organization
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Legal Business Name | INTERVENTIONAL SPORTS & PAIN MANAGEMENT PLLC
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Dates
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Enumeration Date | 06/06/2012
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Last Update Date | 01/27/2016
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Provider Practice Location Address
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Address Line | 9802 FM 1960 BYPASS RD W SUITE 205
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City | HUMBLE
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State | TX
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Zip | 77338-3501
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Country | US
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Telephone | 281-570-2961
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Fax | 281-570-6527
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Provider Business Mailing Address
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Address Line | 9802 FM 1960 BYPASS RD W SUITE 205
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City | HUMBLE
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State | TX
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Zip | 77338-3501
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Country | US
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Telephone | 281-570-2961
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Fax | 281-570-6527
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Authorized Official
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Title or Position | MD/OWNER
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Name | OKEZIE N OKEZIE
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Credential | MD
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Telephone | 713-875-0088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | L5859
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License Number State | TX
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