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Organization
PABJ LP
Active
Organization
PABJ LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID R MACK MD (MANAGING PARTNER)
(281) 664-2107
Entity
Organization
Contact information
Practice address
11800 FM 1960 RD W, HOUSTON, TX 77065-3840
(281) 664-2107
(281) 955-5875
Mailing address
11800 FM 1960 RD W, HOUSTON, TX 77065-3840
(281) 664-2107
(281) 955-5875
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
—
TX
363A00000X
Physician Assistant
PA01427
TX
363A00000X
Physician Assistant
PA02925
TX
363A00000X
Physician Assistant
PA05232
TX
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0033NL
BC/BS PIN
TX
Enumeration date
05/26/2006
Last updated
11/30/2016
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