Provider Demographics
NPI:1720826225
Name:LEG PAIN CLINIC PLLC
Entity type:Organization
Organization Name:LEG PAIN CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:SHAWANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-799-4391
Mailing Address - Street 1:3262 WESTHEIMER RD
Mailing Address - Street 2:PMB 886
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-1002
Mailing Address - Country:US
Mailing Address - Phone:713-242-1139
Mailing Address - Fax:832-410-3994
Practice Address - Street 1:11240 FM 1960 RD W STE 406
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-3663
Practice Address - Country:US
Practice Address - Phone:713-242-1139
Practice Address - Fax:832-410-3994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-18
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty