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Organization
DYNAMIC SPORTS MEDICINE AND PAIN SOLUTIONS PLLC
Active
Organization
DYNAMIC SPORTS MEDICINE AND PAIN SOLUTIONS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICAL SAMUELSON DUVALL MD (PRESIDENT)
(210) 602-5578
Entity
Organization
Contact information
Practice address
7830 W GRAND PKWY S, SUITE 150, RICHMOND, TX 77406-5816
(832) 302-6212
Mailing address
41922 N MILL DR, MAGNOLIA, TX 77354-1850
(210) 602-5578
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
Q0169
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1669600324
NPI
TX
Enumeration date
03/08/2016
Last updated
03/08/2016
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