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General NPI Number Information
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NPI Number | 1164547733
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Entity Type | Organization
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Legal Business Name | NEUROSURGICAL AND SPINE CONSULTANTS, PA
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 1001 12TH AVE STE 171
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City | FORT WORTH
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State | TX
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Zip | 76104-3926
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Country | US
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Telephone | 817-576-6500
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Fax | 682-703-2064
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Provider Business Mailing Address
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Address Line | 1001 12TH AVE STE 171
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City | FORT WORTH
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State | TX
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Zip | 76104-3926
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Country | US
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Telephone | 817-576-6500
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Fax | 682-703-2064
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | CRISTYL CHANCE
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Credential |
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Telephone | 817-715-0409
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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