Healthcare Provider Details

I. General information

NPI: 1912413253
Provider Name (Legal Business Name): ORTHO NEURO SPINE CONSULTANTS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2017
Last Update Date: 12/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20635 KUYKENDAHL RD
SPRING TX
77379-3533
US

IV. Provider business mailing address

PO BOX 11975
SPRING TX
77391-1975
US

V. Phone/Fax

Practice location:
  • Phone: 832-844-3746
  • Fax: 888-770-6360
Mailing address:
  • Phone: 832-844-3746
  • Fax: 888-770-6360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberL8677
License Number StateTX

VIII. Authorized Official

Name: SYED RASHID
Title or Position: ADMIN
Credential:
Phone: 832-614-2958