Healthcare Provider Details

I. General information

NPI: 1104586916
Provider Name (Legal Business Name): PERFORMANCE SPINE AND BRAIN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2021
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 PECAN PARK AVE STE D
ALEXANDRIA LA
71303-3362
US

IV. Provider business mailing address

PO BOX 11758
ALEXANDRIA LA
71315-1758
US

V. Phone/Fax

Practice location:
  • Phone: 800-238-0827
  • Fax: 318-219-5221
Mailing address:
  • Phone: 800-238-0827
  • Fax: 318-219-5221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PAUL V BIRINYI
Title or Position: CEO
Credential: MD
Phone: 800-238-0827