Basic Information
| Provider Information | |||||||||
| NPI: | 1881085595 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | USPS MEDICAL ASSOCIATES, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8111 SOUTHWEST FWY | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770741705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7139737246 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8111 SOUTHWEST FWY | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770741705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7139737246 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/17/2015 | ||||||||
| LastUpdateDate: | 12/14/2017 | ||||||||
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| AuthorizedOfficialLastName: | BAUMGARTNER | ||||||||
| AuthorizedOfficialFirstName: | EDWARD | ||||||||
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| AuthorizedOfficialTitleorPosition: | MEDICAL DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 7139737246 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | TX | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 208VP0000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pain Medicine | Pain Medicine |
ID Information
| ID | Type | State | Issuer | Description | 355672201 | 05 | TX | MEDICAID | 409802 | 01 | TX | MEDICARE | OTHER |