Provider Demographics
NPI:1831699933
Name:INTEGRATED HEALTH AND PAIN MANAGEMENT PLLC
Entity type:Organization
Organization Name:INTEGRATED HEALTH AND PAIN MANAGEMENT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:SIERRA
Authorized Official - Middle Name:N
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-494-6054
Mailing Address - Street 1:PO BOX 957
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77549-0957
Mailing Address - Country:US
Mailing Address - Phone:469-494-6054
Mailing Address - Fax:
Practice Address - Street 1:1120 NASA PKWY STE 220Q
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3342
Practice Address - Country:US
Practice Address - Phone:469-494-6054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-15
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1144517467OtherNPESS