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General NPI Number Information
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NPI Number | 1528863461
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Entity Type | Organization
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Legal Business Name | BRAIN & SPINE OF TEXAS, PLLC
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Dates
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Enumeration Date | 02/14/2025
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Last Update Date | 02/14/2025
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Provider Practice Location Address
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Address Line | 1200 BROOKLYN AVE STE 305
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City | SAN ANTONIO
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State | TX
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Zip | 78212-4803
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Country | US
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Telephone | 210-757-3217
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Fax | 210-757-3583
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Provider Business Mailing Address
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Address Line | 101 GOLDFINCH LN
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City | WEATHERFORD
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State | TX
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Zip | 76088-2006
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Country | US
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Telephone | 214-538-0168
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | CATHY FISHER
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Credential |
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Telephone | 214-538-0168
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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