1033750880 NPI number — 21ST CENTURY PAIN MANAGEMENT PLLC

Table of content: (NPI 1033750880)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033750880 NPI number — 21ST CENTURY PAIN MANAGEMENT PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
21ST CENTURY PAIN MANAGEMENT PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033750880
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/02/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11601 SHADOW CREEK PKWY
Provider Second Line Business Mailing Address:
SUITE 111 BOX NUMBER 625
Provider Business Mailing Address City Name:
PEARLAND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77584-7283
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-614-9845
Provider Business Mailing Address Fax Number:
832-644-9193

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6534 GREATWOOD PKWY STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUGAR LAND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77479-7222
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-614-9845
Provider Business Practice Location Address Fax Number:
832-644-9193
Provider Enumeration Date:
10/02/2019

Additional Information

Authorized Official

Authorized Official Last Name:
KAMAL
Authorized Official First Name:
JUNAID
Authorized Official Middle Name:
Authorized Official Title or Position:
MEMBER
Authorized Official Telephone Number:
832-289-0529

Provider Taxonomy Codes

  • Taxonomy code: 261QP3300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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