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General NPI Number Information
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NPI Number | 1851850291
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Entity Type | Organization
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Legal Business Name | SPINEMD PLLC
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Dates
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Enumeration Date | 03/15/2019
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Last Update Date | 09/18/2020
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Provider Practice Location Address
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Address Line | 7500 DAVIS BLVD STE 100
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City | NORTH RICHLAND HILLS
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State | TX
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Zip | 76182-7402
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Country | US
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Telephone | 817-893-6001
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Fax | 855-248-1291
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Provider Business Mailing Address
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Address Line | 7500 DAVIS BLVD STE 100
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City | NORTH RICHLAND HILLS
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State | TX
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Zip | 76182-7402
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Country | US
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Telephone | 817-893-6001
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Fax | 855-248-1291
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Authorized Official
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Title or Position | MANAGER
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Name | ANIL KUMAR KESANI
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Credential |
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Telephone | 817-893-6001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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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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