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General NPI Number Information
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NPI Number | 1255806048
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Entity Type | Organization
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Legal Business Name | GBS SPINAL ASSOCIATES LLC
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Dates
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Enumeration Date | 10/08/2018
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Last Update Date | 12/12/2018
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Provider Practice Location Address
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Address Line | 9301 CONNECTICUT DR
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City | CROWN POINT
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State | IN
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Zip | 46307-7486
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Country | US
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Telephone | 574-314-5023
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Fax | 609-925-9007
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Provider Business Mailing Address
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Address Line | 11750 KATY FWY STE 1100
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City | HOUSTON
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State | TX
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Zip | 77079-1257
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Country | US
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Telephone | 574-204-2859
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Fax | 609-925-9007
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Authorized Official
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Title or Position | RCM DIRECTOR
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Name | FRAN PEDANO
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Credential |
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Telephone | 574-204-2859
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State |
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