MEDICARE: ORTHOPAEDIC INSTITUTE FOR SPINAL DISORDERS P A

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207XS0117X	Orthopaedic Surgery of the Spine Physician	H6934	TX
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	207XS0117X	Orthopaedic Surgery of the Spine Physician

General Provider Information

NPI Number	:	1144407032
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORTHOPAEDIC INSTITUTE FOR SPINAL DISORDERS P A

Provider Business Mailing Address
First Line	:	2500 FONDREN RD STE 210
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77063-2313
Country	:	US
Telephone Number	:	713-781-5676
Fax Number	:	713-781-5712

Provider Business Practice Location Address
First Line	:	2500 FONDREN RD STE 210
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77063-2313
Country	:	US
Telephone Number	:	713-781-5676
Fax Number	:	713-781-5712

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	JOSE E RODRIGUEZ
Credential	:	MD
Telephone Number	:	713-781-5676

Provider Enumeration Date	:	01/23/2008
Last Update Date	:	09/27/2024

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