Provider Demographics
NPI:1538627096
Name:ADVANCED SPINE AND PAIN SPECIALISTS
Entity type:Organization
Organization Name:ADVANCED SPINE AND PAIN SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:KHOURY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-298-6903
Mailing Address - Street 1:PO BOX 1315
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77383-1315
Mailing Address - Country:US
Mailing Address - Phone:832-298-6903
Mailing Address - Fax:
Practice Address - Street 1:25305 INTERSTATE 45
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-3534
Practice Address - Country:US
Practice Address - Phone:281-868-7246
Practice Address - Fax:281-868-7246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-04
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty