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General NPI Number Information
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NPI Number | 1144646506
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Entity Type | Organization
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Legal Business Name | TCSPINE, PLLC
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Dates
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Enumeration Date | 03/10/2014
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Last Update Date | 03/13/2014
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Provider Practice Location Address
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Address Line | 800 ORTHOPEDIC WAY
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City | ARLINGTON
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State | TX
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Zip | 76015-1629
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Country | US
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Telephone | 817-261-8272
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 152582
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City | ARLINGTON
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State | TX
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Zip | 76015-8582
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Country | US
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Telephone | 817-261-8272
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Fax |
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Authorized Official
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Title or Position | DELEGATED OFFICIAL
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Name | DR. ERIC SCOTT WIESER
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Credential | M.D.
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Telephone | 817-261-8272
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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