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General NPI Number Information
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NPI Number | 1528265006
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Entity Type | Organization
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Legal Business Name | SPINE CARE SOUTHWEST, PA
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Dates
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Enumeration Date | 06/28/2007
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Last Update Date | 10/07/2008
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Provider Practice Location Address
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Address Line | 7500 BEECHNUT ST STE 150
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City | HOUSTON
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State | TX
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Zip | 77074-4393
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Country | US
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Telephone | 713-773-2273
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Fax | 713-773-0392
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Provider Business Mailing Address
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Address Line | 7500 BEECHNUT 150
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City | HOUSTON
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State | TX
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Zip | 77074
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Country | US
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Telephone | 713-773-2273
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Fax | 713-773-0392
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Authorized Official
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Title or Position | ORTHOPEDIC SPINE SURGERON
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Name | STANLEY C JONES
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Credential | MD
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Telephone | 713-773-2273
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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 | M2377
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | D7607
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License Number State | TX
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