MEDICARE: TEXAS CENTER FOR PAIN MANAGEMENT, PA

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	122300000X	Dentist
2	174400000X	Specialist

General Provider Information

NPI Number	:	1710109889
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEXAS CENTER FOR PAIN MANAGEMENT, PA

Provider Business Mailing Address
First Line	:	12060 BELLAIRE BLVD
Second Line	:	SUITE C
City	:	HOUSTON
State	:	TX
Zip	:	77072-2569
Country	:	US
Telephone Number	:	281-530-9947
Fax Number	:

Provider Business Practice Location Address
First Line	:	12060 BELLAIRE BLVD
Second Line	:	SUITE C
City	:	HOUSTON
State	:	TX
Zip	:	77072-2569
Country	:	US
Telephone Number	:	281-530-9947
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HIEU NGUYEN
Credential	:
Telephone Number	:	281-530-9947

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	10/03/2022

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