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General NPI Number Information
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NPI Number | 1326283300
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Entity Type | Organization
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Legal Business Name | PAIN MANAGEMENT ASSOCIATES, PA
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Dates
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Enumeration Date | 12/04/2008
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Last Update Date | 08/11/2020
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Provider Practice Location Address
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Address Line | 13636 BRETON RIDGE ST STE D
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City | HOUSTON
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State | TX
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Zip | 77070-6077
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Country | US
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Telephone | 832-688-9160
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Fax | 832-688-9251
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Provider Business Mailing Address
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Address Line | 13636 BRETON RIDGE ST STE D
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City | HOUSTON
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State | TX
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Zip | 77070-6077
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Country | US
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Telephone | 832-688-9160
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Fax | 832-688-9251
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. NAVEENDRA KORIVI
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Credential | D.O.
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Telephone | 832-688-9160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | L1360
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License Number State | TX
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