Provider Demographics
NPI:1871775205
Name:SENIOR'S PAIN RELIEF MEDICAL SUPPLY
Entity type:Organization
Organization Name:SENIOR'S PAIN RELIEF MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:PABLO
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-229-9943
Mailing Address - Street 1:20807 FOX CLIFF LN
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-6718
Mailing Address - Country:US
Mailing Address - Phone:832-229-9943
Mailing Address - Fax:281-446-7223
Practice Address - Street 1:16711 N MIST DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77073-5254
Practice Address - Country:US
Practice Address - Phone:832-229-9943
Practice Address - Fax:281-446-7223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-27
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies