NPIMap

Organization Active NPI

Procura Pain and Spine, PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Shenandoah, TX
National Provider Identifier
1245663848
Registry record updated Nov 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
PROCURA PAIN AND SPINE, PLLC
Practice address
111 Vision Park Blvd Ste 100
Shenandoah, TX 77384-3003
Phone
(713) 714-1399
Fax
(713) 389-5798
NPI assigned
Aug 19, 2013
Last updated
Nov 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2025

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

Authorized official

Name
Kenneth Qian Wu, MDNPI 1952632143
Title
Chief Medical Officer
Phone
(713) 714-1399

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 10

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Anesthesiology Physician 207L00000X
Addiction Medicine (Anesthesiology) Physician 207LA0401X
Pain Medicine (Anesthesiology) Physician 207LP2900X Primary
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X
Psychiatry Physician 2084P0800X
Pain Medicine Physician 208VP0000X P0796 TX
Interventional Pain Medicine Physician 208VP0014X
Electrodiagnostic Medicine Physician 204R00000X
Addiction Medicine (Preventive Medicine) Physician 2083A0300X

Addresses

Primary practice location

111 Vision Park Blvd Ste 100
Shenandoah, TX 77384-3003

Mailing address

111 Vision Park Blvd Ste 100
Shenandoah, TX 77384-3003
Phone (713) 714-1399

Other practice location 1

24018 Highway 59 N
Kingwood, TX 77339-1536
Phone (281) 446-4878

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20130904000413 TX Part B Supplier - Clinic/Group Practice 8729221197 Receives reassigned benefits from 11 practitioners
Practice locations: Shenandoah, TX; Kingwood, TX
O20231026000816 TX DME Supplier - Physician - Interventional Pain Management 8729221197 Practice locations: Shenandoah, TX

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
45D2178078Procura Pain and Spine PLLC111 Vision Park Blvd, Suite 100, Shenandoah, TX 77384AccreditationApr 26, 2027

National Provider Directory

National Provider Directory

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 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763078400000",
    "number": "1245663848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 VISION PARK BLVD STE 100",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773843003",
            "telephone_number": "713-714-1399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 VISION PARK BLVD STE 100",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773843003",
            "telephone_number": "713-714-1399",
            "fax_number": "713-389-5798"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24018 Highway 59 N",
            "address_purpose": "LOCATION",
            "city": "Kingwood",
            "state": "TX",
            "postal_code": "773391536",
            "country_code": "US",
            "telephone_number": "281-446-4878",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROCURA PAIN AND SPINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-19",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A",
        "authorized_official_last_name": "WU",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "QIAN",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "713-714-1399",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LA0401X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "TX",
            "license": "P0796",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "204R00000X",
            "taxonomy_group": "",
            "desc": "Electrodiagnostic Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shenandoah, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2025; 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.