Organization
OMAR D. VIDAL M.D. P.L.L.C.
Active
Other names
OMAR D. VIDAL M.D. P.L.L.C.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OMAR DAMASO VIDAL M.D. (DIRECTOR)
(713) 751-0631
Entity
Organization
Contact information
Practice address
2105 JACKSON ST, HOUSTON, TX 77003-5839
(713) 751-0631
(713) 751-0605
Mailing address
2105 JACKSON ST, HOUSTON, TX 77003-5839
(713) 751-0631
(713) 751-0605
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
K8553
TX
208VP0000X
Pain Medicine Physician
K8553
TX
208VP0014X
Interventional Pain Medicine Physician
Primary
K8553
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
P080565G5
—
TX
Enumeration date
05/02/2007
Last updated
01/07/2011
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