| Back Pain And Sciatica Center Of Texas, Pllc | |
|
2510 S Loop 336 W Suite 245 Conroe TX 77304 | |
| (936) 494-1222 | |
| (936) 494-1245 |
| Full Name | Back Pain And Sciatica Center Of Texas, Pllc |
|---|---|
| Speciality | General Practice |
| Location | 2510 S Loop 336 W, Conroe, Texas |
| Authorized Official Name and Position | Harry K Eulitt (PRESIDENT) |
| Authorized Official Contact | 9364941222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Back Pain And Sciatica Center Of Texas, Pllc 2510 S Loop 336 W Suite 245 Conroe TX 77304 Ph: (936) 494-1222 | Back Pain And Sciatica Center Of Texas, Pllc 2510 S Loop 336 W Suite 245 Conroe TX 77304 Ph: (936) 494-1222 |
| NPI Number | 1255853693 |
|---|---|
| Provider Enumeration Date | 07/07/2017 |
| Last Update Date | 01/20/2022 |
| Medicare PECOS PAC ID | 0648697912 |
|---|---|
| Medicare Enrollment ID | O20200901001729 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255853693 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Harry K Eulitt |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1487843389 PECOS PAC ID: 8224187703 Enrollment ID: I20090513000388 |
| Provider Name | Gabbrielle Ann Williams |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1386985711 PECOS PAC ID: 6507009883 Enrollment ID: I20130905000816 |
| Provider Name | Katherine R Watt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619458387 PECOS PAC ID: 4183056310 Enrollment ID: I20191108002351 |
| Provider Name | Lonnie E Piatt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992230221 PECOS PAC ID: 9830516111 Enrollment ID: I20200901002049 |
| Provider Name | Thomas M Johnson |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1982958666 PECOS PAC ID: 4880848019 Enrollment ID: I20230921001532 |
| Provider Name | Tamara Nicole Blanton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558148015 PECOS PAC ID: 7113377953 Enrollment ID: I20231220001534 |
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