Organization Active NPI

Modern Pain Management PLLC

  • Pain Medicine Physician
  • Houston, TX
National Provider Identifier
1013394766
Registry record updated Nov 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
P1162 Issued in TX
Legal business name
MODERN PAIN MANAGEMENT PLLC
Practice address
902 Frostwood
Suite 235
Houston, TX 77024
Phone
(713) 298-0120
Fax
(713) 513-5303
NPI assigned
May 1, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
George Atallah, DONPI 1093940694
Title
Owner
Phone
(713) 298-0120

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X P1162 TX Primary

Addresses

Primary practice location

902 Frostwood
Suite 235
Houston, TX 77024

Mailing address

902 Frostwood
Suite 235
Houston, TX 77024
Phone (713) 298-0120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151214002488 TX Part B Supplier - Clinic/Group Practice 7719288893 Receives reassigned benefits from 6 practitioners
Practice locations: Houston, TX; Sugar Land, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2106747Modern Pain Management PLLC902 Frostwood Dr Suite 235, Houston, TX 77024Certificate of waiverDec 28, 2027

National Provider Directory

National Provider Directory

Locations

902 Frostwood Dr
Ste 235
Houston, TX 77024
Phone (713) 298-0120

12930 Dairy Ashford Rd
Ste 501
Sugar Land, TX 77478
Phone (713) 298-0120

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1430438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446422400000",
    "number": "1013394766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 FROSTWOOD",
            "address_2": "SUITE 235",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77024",
            "telephone_number": "713-298-0120",
            "fax_number": "713-513-5303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 FROSTWOOD",
            "address_2": "SUITE 235",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77024",
            "telephone_number": "713-298-0120",
            "fax_number": "713-513-5303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN PAIN MANAGEMENT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-01",
        "last_updated": "2015-11-02",
        "status": "A",
        "authorized_official_last_name": "ATALLAH",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "713-298-0120",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "TX",
            "license": "P1162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.