| NPI | 1053800391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY ANN JOLLEY Director Of Credentialing 713-458-4169 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 207LP2900X Anesthesiology, Pain Medicine | |
| 208VP0000X Pain Medicine, Pain Medicine | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 367500000X Nurse Anesthetist, Certified Registered | |
| Enumeration Date | 2018-05-02 |
| Last Update Date | 2018-05-30 |