| NPI | 1881130268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOWLVA MICHAEL LEE Provider 832-910-9200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2017-01-10 |
| Last Update Date | 2017-01-10 |