Provential Medical Group

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

Legal business name

PROVENTIAL MEDICAL GROUP

Practice address

21300 Provincial Blvd
Suite 200
Katy, TX 77450

Phone

(713) 562-7890

Fax

(281) 605-4566

NPI assigned

Sep 21, 2018

Organization subpart

No

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

Authorized official

Name

Mark Filley, MD

Title

Director

Phone

(281) 543-0012

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1537488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537488000000",
    "number": "1669956942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10507 E WILDWIND CIR",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773804043",
            "telephone_number": "281-543-0012",
            "fax_number": "281-605-4566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21300 PROVINCIAL BLVD",
            "address_2": "SUITE 200",
            "city": "KATY",
            "state": "TX",
            "postal_code": "77450",
            "telephone_number": "713-562-7890",
            "fax_number": "281-605-4566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVENTIAL MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-21",
        "last_updated": "2018-09-21",
        "status": "A",
        "authorized_official_last_name": "FILLEY",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "281-543-0012",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosperity Counseling Services
• Providence Health Care and Assisted Living
• Provincial Acupuncture & Wellness
• Provincial Park Surgery Center, LLC
• Elise Provost
• Kathy Provost

• Interventional Pain Medicine Physician in Katy, TX
• Providers in Katy, TX by specialty
• Interventional Pain Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.