MEDICARE: DR. MIGUEL ANGEL PAPPOLLA MD, PHD

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	2084N0400X	Neurology Physician	J5436	TX
2	208VP0014X	Interventional Pain Medicine Physician	J5436	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528051646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MIGUEL ANGEL PAPPOLLA MD, PHD

Provider Business Mailing Address
First Line	:	2646 S LOOP W STE 106
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-2676
Country	:	US
Telephone Number	:	713-661-0300
Fax Number	:	281-822-0480

Provider Business Practice Location Address
First Line	:	2646 S LOOP WEST STE 106
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-1901
Country	:	US
Telephone Number	:	713-661-0300
Fax Number	:	281-822-0480

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2005
Last Update Date	:	04/30/2013

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