MEDICARE: SPINE GROUP OF TEXAS, PA

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	171R00000X	Interpreter

General Provider Information

NPI Number	:	1326364241
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPINE GROUP OF TEXAS, PA

Provider Business Mailing Address
First Line	:	530 WELLS FARGO DR
Second Line	:	STE 112
City	:	HOUSTON
State	:	TX
Zip	:	77090-4044
Country	:	US
Telephone Number	:	281-440-3500
Fax Number	:

Provider Business Practice Location Address
First Line	:	530 WELLS FARGO DR
Second Line	:	STE 112
City	:	HOUSTON
State	:	TX
Zip	:	77090-4044
Country	:	US
Telephone Number	:	281-440-3500
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. STEPHEN ESSES
Credential	:	M.D.
Telephone Number	:	713-594-4623

Provider Enumeration Date	:	04/16/2010
Last Update Date	:	04/16/2010

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