Healthcare Provider Details

I. General information

NPI: 1215405402
Provider Name (Legal Business Name): HOUSTON SCOLIOSIS & SPINE INSTITUTE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2018
Last Update Date: 11/24/2020
Certification Date: 11/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3534 VISTA RD STE 2000
PASADENA TX
77504-1728
US

IV. Provider business mailing address

3534 VISTA RD STE 2000
PASADENA TX
77504-1728
US

V. Phone/Fax

Practice location:
  • Phone: 346-291-5357
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State

VIII. Authorized Official

Name: RA'KERRY RAHMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 346-250-2590