MEDICARE: ADVANCED INVASIVE PAIN MANAGEMENT OF HOUSTON

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	174400000X	Specialist

General Provider Information

NPI Number	:	1659716942
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED INVASIVE PAIN MANAGEMENT OF HOUSTON

Provider Business Mailing Address
First Line	:	308 W PARKWOOD AVE
Second Line	:	SUITE 106
City	:	FRIENDSWOOD
State	:	TX
Zip	:	77546-5478
Country	:	US
Telephone Number	:	713-943-7246
Fax Number	:	713-943-2040

Provider Business Practice Location Address
First Line	:	26103 INTERSTATE 45 N
Second Line	:	SUITE 100
City	:	THE WOODLANDS
State	:	TX
Zip	:	77380-1902
Country	:	US
Telephone Number	:	713-943-7246
Fax Number	:

Authorized Official
Title or Position	:	BILLING
Name	:	MRS. HEATHER BALLARD
Credential	:
Telephone Number	:	713-943-7246

Provider Enumeration Date	:	05/01/2013
Last Update Date	:	05/01/2013

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