Healthcare Provider Details

I. General information

NPI: 1518676006
Provider Name (Legal Business Name): TEXAS BRAIN AND SPINE INSTITUTE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2022
Last Update Date: 11/23/2022
Certification Date: 11/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2705 W ARKANSAS LN
DALWORTHINGTON GARDENS TX
76016-5818
US

IV. Provider business mailing address

2705 W ARKANSAS LN
DALWORTHINGTON GARDENS TX
76016-5818
US

V. Phone/Fax

Practice location:
  • Phone: 817-701-4253
  • Fax: 817-701-4258
Mailing address:
  • Phone: 817-701-4253
  • Fax: 817-701-4258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SABATINO BIANCO
Title or Position: OWNER
Credential: MD
Phone: 817-701-4253