=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174126734
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | OMNI SPINE PAIN MANAGEMENT, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/17/2020
-----------------------------------------------------
Last Update Date | 10/29/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 270 S COLLINS RD STE 200
-----------------------------------------------------
City | SUNNYVALE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75182-4642
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-705-1200
-----------------------------------------------------
Fax | 214-705-1201
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8380 WARREN PKWY STE 100
-----------------------------------------------------
City | FRISCO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75034-4199
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-705-1200
-----------------------------------------------------
Fax | 214-705-1201
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ANDREW HENRY MORCHOWER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 214-705-1200
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208VP0014X
-----------------------------------------------------
Taxonomy Name | Interventional Pain Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------