| NPI | 1861061749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID EIDSELON Manager 832-919-8080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2021-06-23 |
| Last Update Date | 2024-08-05 |