Healthcare Provider Details

I. General information

NPI: 1053076950
Provider Name (Legal Business Name): MINIMALLY INVASIVE NEUROSURGERY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2021
Last Update Date: 10/03/2022
Certification Date: 10/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 E TAYLOR ST STE 308
SHERMAN TX
75090-2826
US

IV. Provider business mailing address

1811 MEADOW RANCH RD
MCKINNEY TX
75071-6498
US

V. Phone/Fax

Practice location:
  • Phone: 469-947-7463
  • Fax:
Mailing address:
  • Phone: 469-947-7463
  • Fax:

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. ABDUL BAKER
Title or Position: OWNER
Credential: MD
Phone: 270-227-1679