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General NPI Number Information
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NPI Number | 1487941043
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Entity Type | Organization
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Legal Business Name | PREMIER PAIN & WELLNESS CENTER PLLC
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Dates
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Enumeration Date | 07/05/2011
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Last Update Date | 07/07/2011
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Provider Practice Location Address
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Address Line | 1398 ELDRIDGE PKWY SUITE 100
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City | HOUSTON
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State | TX
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Zip | 77077-2547
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Country | US
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Telephone | 409-939-9940
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Fax |
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Provider Business Mailing Address
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Address Line | 1398 ELDRIDGE PKWY SUITE 100
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City | HOUSTON
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State | TX
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Zip | 77077-2547
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Country | US
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Telephone | 409-939-9940
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER OWNER
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Name | VU PHI TRAN
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Credential | MD
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Telephone | 409-939-9940
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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 | N5439
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License Number State | TX
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