Provider Demographics
NPI:1013113810
Name:BRAE VALLEY PAIN & ASSOCIATES, P.A.
Entity type:Organization
Organization Name:BRAE VALLEY PAIN & ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-636-2590
Mailing Address - Street 1:2646 S LOOP WEST
Mailing Address - Street 2:SUITE 440
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-5616
Mailing Address - Country:US
Mailing Address - Phone:713-636-2590
Mailing Address - Fax:
Practice Address - Street 1:2646 S LOOP WEST
Practice Address - Street 2:SUITE 440
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-5616
Practice Address - Country:US
Practice Address - Phone:713-636-2590
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00Y892Medicare PIN
TX00Y891Medicare PIN