Basic Information
| Provider Information | |||||||||
| NPI: | 1366830614 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HOUSTON SPINE & JOINT PAIN CONSULTANTS PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4101 GREENBRIAR DR # 208 | ||||||||
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| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770985294 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8327777246 | ||||||||
| FaxNumber: | 8327067777 | ||||||||
| Practice Location | |||||||||
| Address1: | 4101 GREENBRIAR DR # 208 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770985294 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8325381024 | ||||||||
| FaxNumber: | 8325381023 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/08/2015 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| AuthorizedOfficialLastName: | TARIQ | ||||||||
| AuthorizedOfficialFirstName: | SHABREZ | ||||||||
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| AuthorizedOfficialTitleorPosition: | MD | ||||||||
| AuthorizedOfficialTelephone: | 8327777246 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208VP0000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pain Medicine | Pain Medicine |
No ID Information.