Organization
ADVANCED PAIN AND HEADACHE MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IBETT ROBLES (MANAGER)
(713) 530-0003
Entity
Organization
Contact information
Practice address
4151 SOUTHWEST FWY STE 720, HOUSTON, TX 77027-7308
(713) 530-0003
Mailing address
PO BOX 980101, HOUSTON, TX 77254
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
—
—
305R00000X
Preferred Provider Organization
Primary
—
—
Other
Enumeration date
04/13/2017
Last updated
04/13/2017
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