Healthcare Provider Details

I. General information

NPI: 1730342692
Provider Name (Legal Business Name): PERSONA SPINE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2008
Last Update Date: 07/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9180 KATY FWY STE 202
HOUSTON TX
77055-7443
US

IV. Provider business mailing address

7500 BEECHNUT ST STE 150
HOUSTON TX
77074-4393
US

V. Phone/Fax

Practice location:
  • Phone: 713-647-7700
  • Fax: 713-647-7702
Mailing address:
  • Phone: 713-773-2273
  • Fax: 713-773-0392

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. STANLEY CHARLES JONES
Title or Position: MANAGER
Credential:
Phone: 713-773-2273