Organization
PREMIER PAIN MANAGEMENT CONSULTANTS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRAMODH K WADERA M.D., (PRESIDENT)
(281) 265-0774
Entity
Organization
Contact information
Practice address
305 SANDY CORNER RD, SUITE # 220, EL CAMPO, TX 77437-9535
(281) 265-0774
(281) 265-0774
Mailing address
PO BOX 16404, SUGAR LAND, TX 77496-6404
(281) 265-0774
(281) 265-0774
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
G1575
TX
208VP0014X
Interventional Pain Medicine Physician
Primary
G1575
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
176808701
—
TX
05
—
176808702
—
TX
Enumeration date
07/21/2006
Last updated
12/27/2012
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