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General NPI Number Information
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NPI Number | 1861931560
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Entity Type | Organization
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Legal Business Name | OMNI SPINE PAIN MANAGEMENT, PLLC
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Dates
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Enumeration Date | 02/15/2017
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Last Update Date | 02/15/2017
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Provider Practice Location Address
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Address Line | 4500 HILLCREST RD SUITE 185
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City | FRISCO
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State | TX
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Zip | 75035-5418
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Country | US
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Telephone | 214-705-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 4500 HILLCREST RD SUITE 185
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City | FRISCO
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State | TX
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Zip | 75035-5418
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | ANDREW MORCHOWER
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Credential |
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Telephone | 214-705-1200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P0004X
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Taxonomy Name | Spinal Cord Injury Medicine Physician
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License Number | N4020
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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