MEDICARE: BRAE VALLEY PAIN & ASSOCIATES, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician

General Provider Information

NPI Number	:	1013113810
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRAE VALLEY PAIN & ASSOCIATES, P.A.

Provider Business Mailing Address
First Line	:	2646 S LOOP WEST
Second Line	:	SUITE 440
City	:	HOUSTON
State	:	TX
Zip	:	77054-5616
Country	:	US
Telephone Number	:	713-636-2590
Fax Number	:

Provider Business Practice Location Address
First Line	:	2646 S LOOP WEST
Second Line	:	SUITE 440
City	:	HOUSTON
State	:	TX
Zip	:	77054-5616
Country	:	US
Telephone Number	:	713-636-2590
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	EDWARD RAMSEY
Credential	:
Telephone Number	:	713-636-2590

Provider Enumeration Date	:	06/27/2007
Last Update Date	:	04/04/2012

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