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General NPI Number Information
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NPI Number | 1891690384
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Entity Type | Organization
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Legal Business Name | TEXAS SPINE AND SPORTS THERAPY CENTER
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Dates
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Enumeration Date | 10/13/2026
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Last Update Date | 10/13/2026
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Provider Practice Location Address
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Address Line | 12501 HYMEADOW DR STE 1F
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City | AUSTIN
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State | TX
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Zip | 78750-1831
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Country | US
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Telephone | 512-436-8900
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Fax | 512-436-8001
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Provider Business Mailing Address
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Address Line | 12501 HYMEADOW DR STE 1F
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City | AUSTIN
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State | TX
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Zip | 78750-1831
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Country | US
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Telephone | 512-436-8900
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Fax | 512-436-8001
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MR. BRIAN CLUKIE
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Credential |
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Telephone | 813-388-2935
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number |
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License Number State |
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