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General NPI Number Information
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NPI Number | 1194033290
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Entity Type | Organization
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Legal Business Name | ADVANCED INVASIVE PAIN MANAGEMENT OF HOUSTON, PA
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Dates
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Enumeration Date | 09/23/2010
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Last Update Date | 09/23/2010
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Provider Practice Location Address
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Address Line | 4301 VISTA RD
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City | PASADENA
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State | TX
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Zip | 77504-2117
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Country | US
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Telephone | 713-943-7246
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5807
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City | KINGWOOD
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State | TX
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Zip | 77325-5807
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Country | US
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Telephone | 713-943-7246
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Fax | 713-943-2040
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JERRY M KEEPERS
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Credential | MD
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Telephone | 713-943-7246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | G1453
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License Number State | TX
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