MEDICARE: 21ST CENTURY PAIN MANAGEMENT PLLC

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	261QP3300X	Pain Clinic/Center
2	207L00000X	Anesthesiology Physician

General Provider Information

NPI Number	:	1033750880
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	21ST CENTURY PAIN MANAGEMENT PLLC

Provider Business Mailing Address
First Line	:	11601 SHADOW CREEK PKWY
Second Line	:	SUITE 111 BOX NUMBER 625
City	:	PEARLAND
State	:	TX
Zip	:	77584-7283
Country	:	US
Telephone Number	:	832-614-9845
Fax Number	:	832-644-9193

Provider Business Practice Location Address
First Line	:	6534 GREATWOOD PKWY STE A
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-7222
Country	:	US
Telephone Number	:	832-614-9845
Fax Number	:	832-644-9193

Authorized Official
Title or Position	:	MEMBER
Name	:	JUNAID KAMAL
Credential	:	MD
Telephone Number	:	832-289-0529

Provider Enumeration Date	:	10/02/2019
Last Update Date	:	01/02/2026

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