Provider Demographics
NPI:1588763106
Name:SOUTHERN PAIN INSTITUTE, P.A.
Entity type:Organization
Organization Name:SOUTHERN PAIN INSTITUTE, P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SON
Authorized Official - Middle Name:K
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-759-0932
Mailing Address - Street 1:1120A DENNIS ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-1102
Mailing Address - Country:US
Mailing Address - Phone:713-759-0932
Mailing Address - Fax:713-759-0966
Practice Address - Street 1:111 VISION PARK BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384-3002
Practice Address - Country:US
Practice Address - Phone:713-759-0932
Practice Address - Fax:713-759-0966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty