Provider Demographics
NPI:1386731834
Name:NEUROLOGY HEADACHE & PAIN CONTROL CENTER, PA
Entity type:Organization
Organization Name:NEUROLOGY HEADACHE & PAIN CONTROL CENTER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MOSHE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-728-9360
Mailing Address - Street 1:1202 NASA PKWY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3304
Mailing Address - Country:US
Mailing Address - Phone:281-338-7246
Mailing Address - Fax:281-335-5706
Practice Address - Street 1:1202 NASA PKWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3304
Practice Address - Country:US
Practice Address - Phone:281-338-7246
Practice Address - Fax:281-335-5706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ24782084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF23786Medicare UPIN