Advanced Pain Management PLLC
Organization Active NPI Pain Medicine Physician · Webster, TX
NPI 1669906608 · NPPES record last updated Nov 24, 2020
Key facts
- NPI
- 1669906608
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pain Medicine Physician 208VP0000X
- Legal business name
- ADVANCED PAIN MANAGEMENT PLLC
- Practice address
- 220 E Medical Center Blvd
Webster, TX 77598-4319 - Phone
- (832) 930-9001
- Fax
- (281) 672-7162
- NPI assigned
- Apr 17, 2017
- Organization subpart
- No
Authorized official
- Name
- Mohamad Azzam, M.D.
- Title
- Owner
- Phone
- (832) 930-9001
Member organizations 1
Practitioners 12
-
Mohamad Ali Azzam, M.D.
-
Rachel Austin Thompson, AGACNP
-
Amber Marie Cunningham, PA-C
-
Neha Patel, PA-C
-
Naushin Prasla, PA-C
-
Anna Marie Rabalais, PA-C
-
Debbie Mathew, NP
-
Jordan Brown, PA-C
-
Janki Patel, PA
-
Mohammad J Baba, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170606001094 | TX | Part B Supplier - Clinic/Group Practice | 2062789480 |
Receives reassigned benefits from 11 practitioners Practice locations: Webster, TX |
| O20170927003985 | TX | DME Supplier - Physician - Anesthesiology | 2062789480 | Practice locations: Webster, TX |
National Provider Directory
Locations
600 N Kobayashi
Ste 311
Webster, TX 77598
Phone (281) 724-4711
Interoperability endpoints
- https://api.platform.athenahealth.com/23637/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine Physician |
208VP0000X | Yes |
Addresses
Primary practice location
220 E Medical Center Blvd
Webster, TX 77598-4319
Mailing address
PO Box 58383
Webster, TX 77598-8383
Phone (832) 930-9001
Other providers in Webster, TX
- Advanced Chiropractic Specialist Center, P.a.
- Advanced Chiropractic Specialist Center, P.a.
- Advanced Colon Care, PLLC
- Advanced Compounding Enterprises
- Advanced Lifts & Accessibility, Inc
- Advantage Physical Therapy
- Ruth Adzuara
- Aeris Laboratory
- Benjamin Michael Aertker
- Afya Specialty Pharmacy LLC
All providers in Webster, TX · Pain Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 24, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.