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1669956942
PROVENTIAL MEDICAL GROUP
KATY, TX
NPI
1669956942
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Entity Type
Organization
Authorized Contact
MARK FILLEY
Director
281-543-0012
Organization Subpart ?
No
Primary Taxonomy
208VP0014X Pain Medicine, Interventional Pain Medicine
Enumeration Date
2018-09-21
Last Update Date
2018-09-21
Business Address
PROVENTIAL MEDICAL GROUP
21300 PROVINCIAL BLVD SUITE 200
KATY, TX 77450
Phone number: 713-562-7890
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Mailing Address
PROVENTIAL MEDICAL GROUP
10507 E WILDWIND CIR
SPRING, TX 77380-4043
Phone number: 281-543-0012
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